Relationship between serum uric acid levels and urinary albumin excretion in patients with heart failure

2008 ◽  
Vol 63 (2) ◽  
pp. 191-195 ◽  
Author(s):  
M. Pinelli ◽  
M. Bindi ◽  
F. Moroni ◽  
M. Castiglioni

Background: Microalbuminuria is a known risk factor for the development of clinical nephropathy in diabetes and also an independent risk factor for cardiovascular disease. Microalbuminuria is a marker of a pathophysiological process that causes both increased renal albumin loss and atherothrombosis. Microalbuminuria is hallmark for early detection of diabetic nephropathy. An elevated urinary albumin excretion is a marker of endothelial dysfunction that symbolizes the kidney’s way to translate the existence of vascular damage. The aim of this study was to evaluate the independent determinants of urinary albumin excretion, and association between biochemical parameters and socio-demographic factors in Diabetic patients. Materials and Methods: This is a hospital based cross sectional study included diagnosed case of Diabetic patients. Serum uric acid concentrations were measured by enzymatic method (uricase-peroxidase), HbA1c was measured using the principle of dry chemistry, Blood Sugar measured by Glucose oxidase peroxidase (GOD/POD) method and urinary albumin excretion was measured with an immunoturbidometric assay. Results: Based on categorization of Urinary albumin excretion, 65% normoalbuminuric, 27% microalbuminuric and 8% macroalbuminuric are found in our study population. The frequency of hyperuricemia was found to be 43%. The prevalence of albuminuria ncreased significantly with increasing glycaemia. Pearsons Correlation coefficient by bivariate analysis of Urinary albumin excretion with confounding variables shows significant positive correlation with onset of DM (r=0.203, P=0.013), Systolic Blood Pressure (r=0.355, P=0.001), Diastolic Blood Pressure (r=0.405, P=0.001), Uricacid (r=0.352, P=0.001), HbA1c (r=0.212, P=0.005) and Smoking (r=0.265, P=0.01). Multiple regression test shows that independent determinant of UAE are Blood Pressure {Diastolic (β=0.313, P=0.006) /Systolic (β=0.309, P=0.002)}, HbA1c (β=0.187, P=0.010), Uric acid (β=0.331, P=0.0001) and Onset of DM (β=0.199,P=0.041). Conclusion: Albuminuria is therefore an important risk factor to measure in patients at risk. The findings extend the relationship between confounding variables and the urinary albumin excretion which emphasize on the importance of screening for icroalbuminuria, Serum Uric Acid to prevent renal dysfunction, HbA1c measurement on a regular interval for good glycemic control and the other variables for regular physiological process of body. Further examination is needed in a large population size to clarify the validity between the biochemical parameters


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 339-OR
Author(s):  
PETTER BJORNSTAD ◽  
LORI M. LAFFEL ◽  
JANE L. LYNCH ◽  
LAURE EL GHORMLI ◽  
RUTH S. WEINSTOCK ◽  
...  

2016 ◽  
Vol 57 (2) ◽  
pp. 119 ◽  
Author(s):  
RajuKumar Dubey ◽  
Sunita Neupane ◽  
Narayan Gautam ◽  
KrishnaKumar Agrawal ◽  
Archana Jayan ◽  
...  

2010 ◽  
Vol 3 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Serge Masson ◽  
Roberto Latini ◽  
Valentina Milani ◽  
Luciano Moretti ◽  
Maria Grazia Rossi ◽  
...  

2020 ◽  
Vol 26 (11) ◽  
pp. 968-976
Author(s):  
HIRONORI Yamamoto ◽  
YUJI NAGATOMO ◽  
KEITARO MAHARA ◽  
TSUTOMU YOSHIKAWA

2012 ◽  
Vol 14 (4) ◽  
pp. 367-376 ◽  
Author(s):  
Masanobu Miura ◽  
Nobuyuki Shiba ◽  
Kotaro Nochioka ◽  
Tsuyoshi Takada ◽  
Jun Takahashi ◽  
...  

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Selvaraj ◽  
B.L Claggett ◽  
D.V Veldhuisen ◽  
I.S Anand ◽  
B Pieske ◽  
...  

Abstract Background Serum uric acid (SUA) is a biomarker of several pathobiologies relevant to the pathogenesis of heart failure with preserved ejection fraction (HFpEF), though by itself may also worsen outcomes. In HF with reduced EF, SUA is independently associated with adverse outcomes and sacubitril/valsartan reduces SUA compared to enalapril. These effects in HFpEF have not been delineated. Purpose To determine the prognostic value of SUA, relationship of change in SUA to quality of life and outcomes, and influence of sacubitril/valsartan on SUA in HFpEF. Methods We analyzed 4,795 participants from the Prospective Comparison of ARNI with ARB Global Outcomes in HF with Preserved Ejection Fraction (PARAGON-HF) trial. We related baseline hyperuricemia to the primary outcome (CV death and total HF hospitalization), its components, myocardial infarction or stroke, and a renal composite outcome. At the 4-month visit, the relationship between SUA change and Kansas City Cardiomyopathy Questionnaire overall summary score (KCCQ-OSS) and several biomarkers including N-terminal pro-B-type natriuretic peptide (NT-proBNP) were also assessed. We simultaneously adjusted for baseline and time-updated SUA to determine whether lowering SUA was associated with clinical benefit. Results Average age was 73±8 years and 52% were women. After multivariable adjustment, hyperuricemia was associated with increased risk for most outcomes (primary outcome HR 1.61, 95% CI 1.37, 1.90, Fig 1A). The treatment effect of sacubitril/valsartan for the primary outcome was not modified by baseline SUA (interaction p=0.11). Sacubitril/valsartan reduced SUA −0.38 mg/dL (95% CI: −0.45, −0.31) compared with valsartan (Fig 1B), with greater effect in those with baseline hyperuricemia (−0.50 mg/dL) (interaction p=0.013). Change in SUA was independently and inversely associated with change in KCCQ-OSS (p=0.019) and eGFR (p<0.001), but not NT-proBNP (p=0.52). Time-updated SUA was a stronger predictor of adverse outcomes over baseline SUA. Conclusions SUA independently predicts adverse outcomes in HFpEF. Sacubitril/valsartan significantly reduces SUA compared to valsartan, an effect that was stronger in those with higher baseline SUA, and reducing SUA was associated with improved outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Novartis


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