Serum uric acid as an index of impaired renal function in congestive heart failure

Background: Related studies have demonstrated a relationship of elevated serum uric levels with a decline in kidney function. However, limited evidence exists in a Southeast Asian community-based population. Objective: The study aimed to examine the relationship between serum uric acid levels and impaired renal function. Methods: A prospective cohort study was conducted in the Thai army health checkup population between July 1, 2006 and December 31, 2012. Inclusion criteria included age older than 20 years and baseline estimated glomerular filtration rate (eGFR) over 60 mL/min/1.73 m2. Cox regression analysis was used to evaluate the association between incidence of impaired renal function and baseline serum uric acid quartiles. Impaired renal function was defined as eGFR <60 mL/min/1.73 m2 over 3 months. Results: A total of 9,534 participants (7,474 men and 2,060 women) were enrolled. Cox regression analysis revealed a significant association of serum uric acid level with impaired renal function in the whole population as the unadjusted hazard ratio (HR) (95% CI) of impaired renal function in second, third, and fourth quartiles were 2.1 (1.39, 3.17), 2.39 (1.6, 3.59), and 3.94 (2.71, 5.74), respectively, when compared with serum uric acid in the first quartile, respectively. After adjusting in 2 models, the HR still significantly persisted with similar magnitudes in all quartiles. Higher incidences of impaired renal function were observed among males than among females in all quartiles. Kaplan-Meier curve showed better renal survival rate in the lower quartile groups. Linear regression analysis showed that eGFR negatively correlated with serum uric acid (r = −0.213, p < 0.001). Conclusion: Our study suggests that an independent association exists of serum uric acid levels with the incidence of impaired renal function and renal progression in the Southeast Asian community-based population.

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Survival after Stenting of Severe Atherosclerotic Ostial Renal Artery Stenoses

Journal of Endovascular Therapy ◽

10.1177/152660280301000320 ◽

2003 ◽

Vol 10 (3) ◽

pp. 539-545 ◽

Cited By ~ 19

Author(s):

Thomas Zeller ◽

Christian Müller ◽

Ulrich Frank ◽

Karlheinz Bürgelin ◽

Uwe Schwarzwälder ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Renal Function ◽

Left Ventricle ◽

Impaired Renal Function ◽

Term Survival ◽

Baseline Serum ◽

Left Ventricle Function ◽

Ventricle Function

Purpose: To examine long-term survival after angioplasty and stenting of atherosclerotic renal artery stenosis (RAS). Methods: Over a 5-year period, 241 consecutive patients (153 men; mean age 67±9 years, range 44–84) were treated with angioplasty and stent implantation for 355 ostial renal stenoses >70%. The procedures were performed in standard fashion using a variety of stents. For survival analysis, the patients were divided into 3 groups based on baseline creatinine levels: group 1: 115 (48%) patients with normal renal function (creatinine <1.2 mg/dL); group 2: 93 (39%) patients with moderately impaired renal function (creatinine 1.2 to 2.5 mg/dL); and group 3: 33 (13%) patients with severely impaired renal function (creatinine >2.5 mg/dL). Results: All patients were treated successfully without any procedure-related mortality. The 30-day mortality was 0.4% (1/241). Twenty-two patients died during a follow-up of 27±15 months (range 1–60) (overall survival 91%). The causes of death were cardiac (congestive heart failure or myocardial infarction, 73%), stroke (13.5%), and malignant disease (13.5%). The survival rate was significantly lower (29.6%) in patients with a baseline serum creatinine >2.5 mg/dL (p<0.0001) than in groups 2 (89.1%) or 1 (95.4%). Long-term survival without hemodialysis or restenosis was 66.6% at 48 months. Independent predictors for a reduced survival were left ventricle function (HR 2.59, 95% CI 1.45 to 4.63, p=0.001 for each 15% incremental decrease), age (HR 1.13, 95% CI 1.03 to 1.25, p=0.011), and baseline renal function (HR 1.58, 95% CI 1.10 to 2.29, p=0.014). Conclusions: Survival after successful stenting for severe ostial RAS depends on baseline serum creatinine and left ventricle function. Efforts must be made to avoid the development of advanced ischemic nephropathy and congestive heart failure.

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A role for the Reitan catheter pump for percutaneous cardiac circulatory support of patients presenting acute congestive heart failure with low output and renal dysfunction?

Future Cardiology ◽

10.2217/fca-2019-0080 ◽

2020 ◽

Vol 16 (3) ◽

pp. 159-164

Author(s):

Julien Regamey ◽

Nicolas Barras ◽

Marco Rusca ◽

Roger Hullin

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Renal Function ◽

Renal Dysfunction ◽

Impaired Renal Function ◽

Acute Decompensated Heart Failure ◽

Vascular Complications ◽

Decompensated Heart Failure ◽

Circulatory Support ◽

Heart Failure Patients

Outcomes in acute decompensated heart failure remain poor, in particular when patients present with impaired renal function. Recent results indicate that treatment of acute decompensated heart failure patients with the Reitan catheter pump not only increases cardiac index, but also improves renal function resulting in maintained increase of diuresis. These favorable effects were achieved without significant hemolysis, bleeding or vascular complications suggesting that Reitan catheter pump treatment has the potential to facilitate recovery from acute decompensated heart failure with low output and complicated by renal dysfunction.

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240 Elevated serum uric acid levels are associated with diastolic dysfunction in patients with congestive heart failure

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(05)80133-x ◽

2005 ◽

Vol 4 (1) ◽

pp. 50-50

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Uric Acid ◽

Diastolic Dysfunction ◽

Serum Uric Acid ◽

Elevated Serum

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Effects of calcium supplementation on bone loss and fractures in congestive heart failure

Acta Endocrinologica ◽

10.1530/eje-06-0614 ◽

2007 ◽

Vol 156 (3) ◽

pp. 309-314 ◽

Cited By ~ 27

Author(s):

Robert J A Frost ◽

Carolin Sonne ◽

Uli Wehr ◽

Hans-Ulrich Stempfle

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Renal Function ◽

Bone Resorption ◽

Bone Loss ◽

Secondary Hyperparathyroidism ◽

Impaired Renal Function ◽

Calcium Supplementation ◽

Fracture Incidence ◽

Prospective Longitudinal

Background: Cross-sectional studies have shown that more than 50% of patients with congestive heart failure (CHF) have decreased bone mineral density (BMD). There is limited knowledge about the longitudinal changes of BMD and how to treat bone loss in patients with CHF. Methods: The present study was a prospective, longitudinal trial in which 33 male patients with CHF (ejection fraction (EF): 30±11%) were assigned to 1000 mg calcium supplementation or no supplementation. BMD was measured at the lumbar spine (LS) and the femoral neck (FN) by dual-energy X-ray absorptiometry at baseline and after 12 months. Results: Osteopenia (LS 33% and FN 36%) and osteoporosis (LS 15% and FN 6%) were frequently seen in these patients; 70% showed impaired renal function, 42% secondary hyperparathyroidism, and 33% hypogonadism. Bone resorption markers were strongly elevated and correlated negatively with the EF. Patients without calcium supplementation revealed a reduction of BMD (LS 1.7% and FN 1.9%) within 12 months. The fracture incidence was 6%. Patients with calcium supplementation also demonstrated a 6% fracture incidence and a decrease in BMD (LS 1.2% and FN 1.6%), which was not significantly different from the untreated group. Loss of BMD at FN was only seen in patients with impaired renal function. Conclusions: Patients with CHF demonstrate a progressive decrease in BMD when compared with age-matched healthy individuals. Increased bone resorption due to renal insufficiency with consecutive secondary hyperparathyroidism is a main reason for BMD loss in CHF. Calcium supplementation alone cannot sufficiently prevent the decrease in BMD.

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Hyperkalemia and impaired renal function during treatment with spironolactone in patients with congestive heart failure: Figures from a real world scenario

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(03)82246-5 ◽

2003 ◽

Vol 41 (6) ◽

pp. 265 ◽

Cited By ~ 1

Author(s):

Morten Svensson ◽

Finn Gustafsson ◽

Soeren Galatius ◽

Dan Atar ◽

Per R. Hildebrandt

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Renal Function ◽

Real World ◽

Impaired Renal Function

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Association of Serum Renal Function Levels with Heart Failure Disease in Iraqi Patients

Research Journal of Pharmacy and Technology ◽

10.52711/0974-360x.2021.00433 ◽

2021 ◽

pp. 2464-2466

Author(s):

Jinan Hussein Murtadha ◽

Iman Hashim Abdul Razzaq

Keyword(s):

Heart Failure ◽

Renal Function ◽

Uric Acid ◽

Serum Uric Acid ◽

Failure Group ◽

Heart Failure Patients ◽

Group 2 ◽

Renal Function Tests ◽

Effect Of Age ◽

Group 1

Renal function tests are commonly used in clinical practice to look for renal disease, the most common includes the serum urea, uric acid and creatinine. Heart failure patients have a higher incidence of renal function test abnormalities than individuals who do not have heart failure disease. Fifty subjects of adults (male) were divided in to two groups, 25 subjects (healthy) as control (group1) and 25 subjects with heart failure (group 2). Our results indicate that serum uric acid, urea, and creatinine values were significantly elevated (P≤0.05) in patients group (2) compared with healthy group (1). The results also showed, the effect of age categories on uric acid blood urea nitrogen and creatinine values (P≤0.05) and there were no significant differences between age (41-60) years and (61-80) years. This study also shows a strong correlation between serum uric acid, urea and creatinine values (P≤0.05) in heart failure patients. Conclusion: It concluded from the above finding that there was effect of heart failure disease on renal function levels.

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Prednisone in Uric Acid Lowering in Symptomatic Heart Failure Patients with Hyperuricemia — The PUSH-PATH3 Study

The Journal of Rheumatology ◽

10.3899/jrheum.141037 ◽

2015 ◽

Vol 42 (5) ◽

pp. 866-869 ◽

Cited By ~ 7

Author(s):

Hong Meng ◽

Gang Liu ◽

Jianlong Zhai ◽

Yuzhi Zhen ◽

Qingzhen Zhao ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Uric Acid ◽

Serum Creatinine ◽

Serum Uric Acid ◽

Clinical Status ◽

Safety And Efficacy ◽

Symptomatic Heart Failure ◽

Heart Failure Patients ◽

Short Time

Objective.To determine the safety and efficacy of prednisone in patients with symptomatic heart failure (HF) and hyperuricemia.Methods.Prednisone therapy was administered for a short time to 191 symptomatic HF patients with hyperuricemia (serum uric acid > 7 mg/dl).Results.Prednisone significantly reduced serum uric acid by 2.99 mg/dl (p < 0.01) and serum creatinine by 0.17 mg/dl (p < 0.01). These favorable effects were associated with a remarkable increase in urine output, improvement in renal function, and improvement in clinical status.Conclusion.Prednisone can be used safely in symptomatic HF patients with hyperuricemia.

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