scholarly journals Hyperuricemia and chronic kidney disease: to treat or not to treat

2021 ◽  
Author(s):  
Federica Piani ◽  
Fumihiko Sasai ◽  
Petter Bjornstad ◽  
Claudio Borghi ◽  
Ashio Yoshimura ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Clinical Trials ◽  
Uric Acid ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Filtration Rate ◽  
Mendelian Randomization ◽  
Experimental Studies ◽  
Kidney Injury

Abstract Hyperuricemia is common in chronic kidney disease (CKD) and may be present in 50% of patients presenting for dialysis. Hyperuricemia can be secondary to impaired glomerular filtration rate (GFR) that occurs in CKD. However, hyperuricemia can also precede the development of kidney disease and predict incident CKD. Experimental studies of hyperuricemic models have found that both soluble and crystalline uric acid can cause significant kidney damage, characterized by ischemia, tubulointerstitial fibrosis, and inflammation. However, most Mendelian randomization studies failed to demonstrate a causal relationship between uric acid and CKD, and clinical trials have had variable results. Here we suggest potential explanations for the negative clinical and genetic findings, including the role of crystalline uric acid, intracellular uric acid, and xanthine oxidase activity in uric acid-mediated kidney injury. We propose future clinical trials as well as an algorithm for treatment of hyperuricemia in patients with CKD.

scholarly journals The Role of Hyperuricemia in the Pathogenesis and Progressivity of Chronic Kidney Disease

2021 ◽  
Vol 9 (F) ◽  
pp. 428-435
Author(s):  
Gede Wira Mahadita ◽  
Ketut Suwitra
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Filtration Rate ◽  
Stage Iv ◽  
Review Of The Literature ◽  
The Relationship ◽  
Uric Acid Secretion

In humans, the end product of purine metabolism is uric acid. Over 70% of uric acid is excreted through the kidneys. When renal function is impaired, uric acid secretion is also impaired. This directly correlates the prevalence of hyperuricemia with the severity of chronic kidney disease (CKD). It has been reported that the prevalence of hyperuricemia in patients with Stage I-III CKD is 40–60% and up to 70% in patients with Stage IV-V CKD. Some studies found a link between serum uric acid levels and decreased glomerular filtration rate (GFR), an independent risk factor for CKD development. Because CKD and serum uric acid levels are related, the relationship between the two frequently generates controversy. As such, this review of the literature discusses the role of uric acid in the pathogenesis and progression of CKD.

scholarly journals New mouse model of chronic kidney disease transitioned from ischemic acute kidney injury

2019 ◽  
Vol 317 (2) ◽  
pp. F286-F295 ◽  
Author(s):  
Jin Wei ◽  
Jie Zhang ◽  
Lei Wang ◽  
Shan Jiang ◽  
Liying Fu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Reperfusion Injury ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Kidney Injury

Acute kidney injury (AKI) significantly increases the risk of development of chronic kidney disease (CKD), which is closely associated with the severity of AKI. However, the underlying mechanisms for the AKI to CKD transition remain unclear. Several animal models with AKI to CKD transition have been generated and widely used in research; however, none of them exhibit the typical changes in glomerular filtration rate or plasma creatinine, the hallmarks of CKD. In the present study, we developed a novel model with a typical phenotype of AKI to CKD transition in C57BL/6 mice. In this model, life-threatening ischemia-reperfusion injury was performed in one kidney, whereas the contralateral kidney was kept intact to maintain animal survival; then, after 2 wk of recovery, when the renal function of the injured kidney restored above the survival threshold, the contralateral intact kidney was removed. Animals of this two-stage unilateral ischemia-reperfusion injury model with pedicle clamping of 21 and 24 min exhibited an incomplete recovery from AKI and subsequent progression of CKD with characteristics of a progressive decline in glomerular filtration rate, increase in plasma creatinine, worsening of proteinuria, and deleterious histopathological changes, including interstitial fibrosis and glomerulosclerosis. In conclusion, a new model of the AKI to CKD transition was generated in C57BL/6 mice.

scholarly journals Beyond the tubule: pathological variants of LRP2, encoding the megalin receptor, result in glomerular loss and early progressive chronic kidney disease

2020 ◽  
Vol 319 (6) ◽  
pp. F988-F999
Author(s):  
Jennifer R. Charlton ◽  
Weizhen Tan ◽  
Ghaleb Daouk ◽  
Lisa Teot ◽  
Seymour Rosen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Glomerular Proteinuria ◽  
Increased Risk ◽  
Kidney Injury Molecule 1 ◽  
Deficient Mice

Pathogenic variants in the LRP2 gene, encoding the multiligand receptor megalin, cause a rare autosomal recessive syndrome: Donnai-Barrow/Facio-Oculo-Acoustico-Renal (DB/FOAR) syndrome. Because of the rarity of the syndrome, the long-term consequences of the tubulopathy on human renal health have been difficult to ascertain, and the human clinical condition has hitherto been characterized as a benign tubular condition with asymptomatic low-molecular-weight proteinuria. We investigated renal function and morphology in a murine model of DB/FOAR syndrome and in patients with DB/FOAR. We analyzed glomerular filtration rate in mice by FITC-inulin clearance and clinically characterized six families, including nine patients with DB/FOAR and nine family members. Urine samples from patients were analyzed by Western blot analysis and biopsy materials were analyzed by histology. In the mouse model, we used histological methods to assess nephrogenesis and postnatal renal structure and contrast-enhanced magnetic resonance imaging to assess glomerular number. In megalin-deficient mice, we found a lower glomerular filtration rate and an increase in the abundance of injury markers, such as kidney injury molecule-1 and N-acetyl-β-d-glucosaminidase. Renal injury was validated in patients, who presented with increased urinary kidney injury molecule-1, classical markers of chronic kidney disease, and glomerular proteinuria early in life. Megalin-deficient mice had normal nephrogenesis, but they had 19% fewer nephrons in early adulthood and an increased fraction of nephrons with disconnected glomerulotubular junction. In conclusion, megalin dysfunction, as present in DB/FOAR syndrome, confers an increased risk of progression into chronic kidney disease.

Renal medicine

2012 ◽  
pp. 383-402
Author(s):  
Lesley K Bowker ◽  
James D Price ◽  
Sarah C Smith
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Filtration Rate ◽  
Fluid Challenge ◽  
Kidney Injury ◽  
Injury Management

The ageing kidney 384 Acute kidney injury 386 Acute kidney injury: management 388 HOW TO . . . Perform a fluid challenge in AKI/anuria 389 Chronic kidney disease 392 HOW TO . . . Estimate the glomerular filtration rate 393 Chronic kidney disease: complications 394 Renal replacement therapy: dialysis 396 Renal replacement therapy: transplantation ...

FREQUENCY RISK FACTORS AND OUTCOMES ACUTE KIDNEY INJURY IN THE EARLY PERIOD IN PATIENTS WITH CHRONIC KIDNEY DISEASE AFTER CABG SURGERY

2018 ◽  
Vol 22 (4) ◽  
pp. 96-101 ◽  
Author(s):  
V. V. Bazylev ◽  
A. A. Gornostaev ◽  
A. A. Schegol’kov ◽  
A. V. Bulygin
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Bypass Graft ◽  
Early Period ◽  
Kidney Injury

AIM: To evaluate risk factors and prevalence of acute kidney injury (AKI) in patients with chronic kidney disease (CKD) in the early period after isolated coronary artery bypass graft (CABG).PATIENTS AND METHODS:The study included 830 patients with  isolated CABG. All surgeries were performed in 2016. To evaluate  kidney function in preoperative period glomerular filtration rate  (GFR) was estimated by Chronic Kidney Disease Epidemiology  Collaboration (CKD-EPI) formula. AKI was diagnosed according to  KDIGO criteria. Patients were stratified into two groups according to  estimated glomerular filtration rate (eGFR).RESULTS:The prevalence of AKI in patients group without CKD after CABG was 11,5% (n=59), in CKD-AKI group – 12,3% (n=39).  In patients with CKD and after intraoperative inotropic/vasopressor  therapy use of only 2 medicinal drugs of this group the probability of  AKI development increases 11,16 times (OR 11,46; 95% CI 3,47- 37,83; р<0,01). During complete bypass (CB) when haematocrit  decreases on 1% AKI probability increases on 12,36% (OR 0,89; 95% CI 0,81-0,98; р=0,02). The necessity of haemodialisys,  duration of stay in intensive care unit and hospitalization duration  were equal to all groups. AKI-CKD development significantly increases intrahospital mortality (p<0,05). CONCLUSIONS: History of CKD increases probability of severe AKI and also mortality in early postoperative period. Revealed risk factors for AKI development are potentially modifiable.

scholarly journals TO STUDY THE ETIOLOGICAL PROFILE IN CHRONIC KIDNEY DISEASE PATIENTS

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Dr. Sukh Dev Choudhary ◽  
Dr. Manoj Lakhotia ◽  
Dr. Himanshi Choudhary ◽  
Dr. Ronak Gandhi
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Diabetic Nephropathy ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Unknown Etiology

Background: Chronic Kidney Disease (CKD) is determined by the presence of kidney injury and by the level of renal function, assessed according to the glomerular filtration rate. Methods: This observational case study will be conducted among patients of newly diagnosedor known cases of chronic kidney disease admitted or attending outdoor clinic at Mahatma Gandhi Hospital Jodhpur. Results: Twenty three patients out of 75 were diabetic, 19 patients had chronic kidney disease of unknown etiology and 12 had both DM and HTN, only one patient had CKD because of RCC. Conclusion:  Most common etiologies of CKD patients on hemodialysis are Diabetic nephropathy. Keywords: Chronic Kidney Disease (CKD), Hypertension, Diabetes.

Sign in / Sign up

Export Citation Format

Share Document