Prednisone lowers serum uric acid levels in patients with decompensated heart failure by increasing renal uric acid clearance

2016 ◽  
Vol 94 (7) ◽  
pp. 797-800 ◽  
Author(s):  
Chao Liu ◽  
Yuzhi Zhen ◽  
Qingzhen Zhao ◽  
Jian-Long Zhai ◽  
Kunshen Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Optimal Dose ◽  
Decompensated Heart Failure ◽  
High Dose ◽  
Acid Clearance ◽  
Uric Acid Clearance ◽  
Dose Prednisone ◽  
Medium Dose

Clinical studies have shown that large doses of prednisone could lower serum uric acid (SUA) in patients with decompensated heart failure (HF); however, the optimal dose of prednisone and underlying mechanisms are unknown. Thirty-eight patients with decompensated HF were randomized to receive standard HF care alone (n = 10) or with low-dose (15 mg/day, n = 8), medium-dose (30 mg/day, n = 10), or high-dose prednisone (60 mg/day, n = 10), for 10 days. At the end of the study, only high-dose prednisone significantly reduced SUA, whereas low- and medium-dose prednisone and standard HF care had no effect on SUA. The reduction in SUA in high-dose prednisone groups was associated with a significant increase in renal uric acid clearance. In conclusion, prednisone can reduce SUA levels by increasing renal uric acid clearance in patients with decompensated HF.

On Serum Uric Acid and Endogenic Uric Acid Clearance in Renal Failure

2009 ◽  
Vol 160 (6) ◽  
pp. 503-507 ◽  
Author(s):  
A. KASANEN ◽  
V. KALLIO ◽  
T. MARKKANEN
Keyword(s):  
Renal Failure ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Acid Clearance ◽  
Uric Acid Clearance

scholarly journals Behavioral Characteristics of Gout Patients and Their Impact on the Results of Urate Lowering Therapy

2021 ◽  
Vol 6 (1) ◽  
pp. 13-17
Author(s):  
J. Chen ◽  
P. Zhou ◽  
W. Tan ◽  
M. Zheng ◽  
N. Y. Oshmianska
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Kidney Diseases ◽  
Behavioral Characteristics ◽  
Clearance Ratio ◽  
Heavy Smoking ◽  
Acid Clearance ◽  
Lowering Therapy ◽  
Uric Acid Clearance ◽  
Before And After

Background. Gout is frequently accompanied by hypertension, obesity, and/or impaired glucose tolerance, which are often complicated with heavy smoking and dietary violations, especially in male patients.Objective. To determine the behavioral characteristics of gout patients that could impact the results of urate lowering therapy.Subjects and methods. The relationship between behavioral characteristics and results of urate lowering therapy were investigated in 74 male gout patients of Chengdu Rheumatism Hospital. The results of treatment were evaluated using serum uric acid contents before and after treatment, VAS pain score before and after treatment. Behavioral characteristics for the last ten years (smoking status, daily volume of drinking water, etc.) were accessed by means of retrospective survey.Results. In gout patients with poor treatment response, serum uric acid at the beginning of the treatment was already significantly lower (365.76 ± 163.06 μmol/L); this trend was also noted in a “slow progress” group, while patients with higher serum uric acid before treatment had notably better response to urate lowering therapy. During further analysis age negatively correlated with serum uric acid (r = –0.328; p = 0.002) and uric acid clearance ratio (r = –0.299; p = 0.002).In patients with uric acid clearance ratio above 40 % the prevalence of kidney diseases (stones or dysfunction) was significantly lower compared to other groups. There was no significant influence of hypertension, diabetes mellitus, fatty liver or hyperlipidaemia on uric acid clearance ratio (p > 0.05).Amount of drinking water also influenced the serum uric acid clearance ratio. Bigger amount of patients in the “fast progress” group (40.0 % compared to 30.44 and 25.0 %) tended to drink more water.Conclusion. In most gout patients, serum uric acid levels before treatment acted as the reliable predictor of good response to urate lowering therapy. Treatment response (serum uric acid clearance ratio) correlated positively with the hyperuricemia and drinking sufficient amounts of water, negatively – with prolonged smoking (more than 10 years) and age.

scholarly journals Relationship of hyperuricemia with mortality in heart failure patients with preserved ejection fraction

2015 ◽  
Vol 309 (7) ◽  
pp. H1123-H1129 ◽  
Author(s):  
Takeshi Shimizu ◽  
Akiomi Yoshihisa ◽  
Yuki Kanno ◽  
Mai Takiguchi ◽  
Akihiko Sato ◽  
...  
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Ejection Fraction ◽  
Serum Uric Acid ◽  
Decompensated Heart Failure ◽  
Cardiopulmonary Exercise Test ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
All Cause Mortality ◽  
The Impact

Serum uric acid is a predictor of cardiovascular mortality in heart failure with reduced ejection fraction. However, the impact of uric acid on heart failure with preserved ejection fraction (HFpEF) remains unclear. Here, we investigated the association between hyperuricemia and mortality in HFpEF patients. Consecutive 424 patients, who were admitted to our hospital for decompensated heart failure and diagnosed as having HFpEF, were divided into two groups based on presence of hyperuricemia (serum uric acid ≥7 mg/dl or taking antihyperuricemic agents). We compared patient characteristics, echocardiographic data, cardio-ankle vascular index, and cardiopulmonary exercise test findings between the two groups and prospectively followed cardiac and all-cause mortality. Compared with the non-hyperuricemia group ( n = 170), the hyperuricemia group ( n = 254) had a higher prevalence of hypertension ( P = 0.013), diabetes mellitus ( P = 0.01), dyslipidemia ( P = 0.038), atrial fibrillation ( P = 0.001), and use of diuretics ( P < 0.001). Cardio-ankle vascular index (8.7 vs. 7.5, P < 0.001) and V̇e/V̇co2 slope (34.9 vs. 31.9, P = 0.02) were also higher. In addition, peak V̇o2 (14.9 vs. 17.9 ml·kg−1·min−1, P < 0.001) was lower. In the follow-up period (mean 897 days), cardiac and all-cause mortalities were significantly higher in those with hyperuricemia ( P = 0.006 and P = 0.004, respectively). In the multivariable Cox proportional hazard analyses after adjustment for several confounding factors including chronic kidney disease and use of diuretics, hyperuricemia was an independent predictor of all-cause mortality (hazard ratio 1.98, 95% confidence interval 1.036–3.793, P = 0.039). Hyperuricemia is associated with arterial stiffness, impaired exercise capacity, and high mortality in HFpEF.

P5413Effect of empagliflozin as add-on therapy on serum uric acid level in patients with type 2 diabetes hospitalized for acute decompensated heart failure: a prospective randomized controlled study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Tamaki ◽  
T Yamada ◽  
T Morita ◽  
Y Furukawa ◽  
Y Iwasaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Acid Level ◽  
Acute Decompensated Heart Failure ◽  
Serum Uric Acid Level ◽  
Decompensated Heart Failure ◽  
Sglt2 Inhibitors ◽  
Lower Serum

Abstract Background Elevated serum uric acid (UA) level has been shown to be associated with reduced survival among patients (pts) with heart failure. Sodium glucose cotransporter 2 (SGLT2) inhibitors have been reported to lower serum uric acid level in pts with type 2 diabetes mellitus (T2D). Empagliflozin, one of the SGLT2 inhibitors, has been shown to reduce the risk of cardiovascular mortality in T2D pts with cardiovascular disease, and involvement of UA lowering effect by empagliflozin in the reduction of cardiovascular mortality has been suggested. However, little is known about the effect of empagliflozin as add-on therapy on serum UA level in T2D pts with acute decompensated heart failure (ADHF). Purpose We sought to elucidate the effect of empagliflozin as add-on therapy on serum UA level in T2D pts with ADHF. Methods We enrolled 38 consecutive T2D pts admitted for ADHF. On admission, enrolled pts were randomly assigned in a 1:1 ratio to either empagliflozin add-on therapy (EMPA(+)) or conventional glucose-lowering therapy (EMPA(−)). All pts in EMPA(+) group received empagliflozin (10 mg/day) throughout the study period. Left ventricular ejection fraction (LVEF) was measured at baseline using echocardiography. Body weight and vital signs, such as blood pressure and heart rate, were measured, and blood and urine samples were collected at baseline and 1, 2, 3 and 7 days after randomization. Renal handling of UA was evaluated by fractional excretion of UA (FEUA). Results Twenty pts were assigned to the EMPA(+) group, and 18 pts were assigned to the EMPA(−) group. There were no significant baseline differences in LVEF, plasma brain natriuretic peptide level, body mass index, or serum creatinine level between the EMPA(+) and EMPA(−) groups. In addition, prevalence rate of hyperuricemia, serum UA level, and FEUA did not significantly differ between the two groups at baseline. However, there was significant difference in the change in serum UA level from baseline at 2, 3 and 7 days after randomization between the two groups (Figure A). As a result, serum UA level was significantly lower in the EMPA(+) group than in the EMPA(−) group at 7 days after randomization (6.2±1.8 mg/dL vs 7.8±1.8 mg/dL, p=0.0127). Moreover, FEUN of the EMPA(+) group was significantly higher at 1, 2 and 7 days after randomization (Figure B), which suggested that serum UA level was lowered in the EMPA(+) group by increased urinary excretion of UA. Figure 1 Conclusions This study demonstrated that empagliflozin as add-on therapy can lower serum UA level in T2D pts with ADHF through the effect on the urinary excretion rate of UA.

Serum Uric Acid Increase through the Treatment of Acute Decompensated Heart Failure Might Predict Adverse Outcome

2017 ◽  
Vol 23 (10) ◽  
pp. S60
Author(s):  
Yuji Nagatomo ◽  
Hironori Yamamoto ◽  
Mayuko Tsugu ◽  
Keitaro Mahara ◽  
Mitsuaki Isobe ◽  
...  
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Adverse Outcome ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure

scholarly journals Exercise-Induced Acute Kidney Injury in a Police Officer with Hereditary Renal Hypouricemia

2019 ◽  
Vol 9 (2) ◽  
pp. 92-101 ◽  
Author(s):  
Yoshio Shimizu ◽  
Keiichi Wakabayashi ◽  
Ayako Totsuka ◽  
Yoko Hayashi ◽  
Shusaku Nitta ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Uric Acid ◽  
Police Officer ◽  
Serum Uric Acid ◽  
Kidney Injury ◽  
Occupational Training ◽  
Renal Hypouricemia ◽  
Acid Clearance ◽  
Uric Acid Clearance ◽  
Exercise Induced

Hereditary renal hypouricemia is characterized by hypouricemia with hyper-uric acid clearance due to a defect in renal tubular transport. Patients with hereditary renal hypouricemia have a higher risk of exercise-induced acute kidney injury (EAKI) and reduced kidney function. Although the best preventive measure is avoiding exercise, there are many kinds of jobs that require occupational exercise. A 27-year-old male police officer suffered from stage 3 AKI after performing a 20-m multistage shuttle run test. His mother had previously been diagnosed as having renal hypouricemia at another facility. The patient had reported having hypouricemia during a health check at a previous police station, but his serum uric acid concentration was within the normal range at our hospital. After treatment, he recovered from EAKI and exhibited low serum uric acid and hyper-uric acid clearance. Since the patient desired to continue his career requiring strenuous exercise, it was difficult to establish a preventive plan against the recurrence of EAKI. Patients with hereditary renal hypouricemia who must undergo strenuous occupational anaerobic exercise are at higher risk of developing EAKI than other workers. The risks of EAKI among patients with hypouricemia should be considered when undergoing physical occupational training.

Abstract 12221: Impact of Serum Uric Acid on Mortality in Heart Failure With Preserved Ejection Fraction

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Takeshi Shimizu ◽  
Akiomi Yoshihisa ◽  
Mai Takiguchi ◽  
Shunsuke Miura ◽  
Akihiko Sato ◽  
...  
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Ejection Fraction ◽  
Serum Uric Acid ◽  
Patient Characteristics ◽  
Decompensated Heart Failure ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
All Cause Mortality ◽  
The Impact

Background: Serum uric acid is a predictor of cardiovascular mortality in heart failure with reduced ejection fraction. However, the impact of uric acid on heart failure with preserved ejection fraction (HFpEF) remains unclear. Here we investigated the association between hyperuricemia and mortality in HFpEF patients. Methods and Results: Consecutive 424 patients, who admitted to our hospital for decompensated heart failure and diagnosed as HFpEF, were divided into two groups based on presence of hyperuricemia (serum uric acid ≥ 7 mg/dl). We compared patient characteristics, cardio-ankle vascular index and cardio-pulmonary exercise test findings between the two groups. Furthermore, we prospectively followed cardiac and all-cause mortality. The hyperuricemia group (n=254), as compared with non-hyperuricemia group (n=170), had higher prevalence of male gender (55.5 vs. 41.7%, P=0.005), hypertension (79.9 vs. 69.4%, P=0.013), diabetes mellitus (38.5 vs. 26.4%, P=0.010) and use of diuretics (72.4 vs. 41.7%, P<0.001). Furthermore, the hyperuricemia group had higher levels of B-type natriuretic peptide (112.3 vs. 71.4 pg/ml, P<0.001), lower levels of estimated GFR (53.2 vs. 69.7 ml/min/1.73m 2 , P<0.001), higher cardio-ankle vascular index (8.7 vs. 7.5, P<0.001), lower peak VO 2 (14.9 vs. 17.9 ml/kg/min, P<0.001) and higher VE/VCO 2 slope (34.9 vs. 31.9, P=0.02) compared with non-hyperuricemia group. In the follow up period (mean of 897 days), cardiac and all-cause mortalities were significantly higher in those with hyperuricemia (P=0.006 and P=0.004, respectively). In the multivariable Cox proportional hazard analyses after adjusting for confounding factors including chronic kidney disease and use of diuretics, hyperuricemia was an independent predictor of all-cause mortality (hazard ratio 1.98, P=0.039). Conclusion: Hyperuricemia is associated with arterial stiffness, impaired exercise capacity, and high mortality in HFpEF.

Serum uric acid levels as a predictor of in-hospital death in patients hospitalized for decompensated heart failure

2005 ◽  
Vol 60 (5) ◽  
pp. 489-492 ◽  
Author(s):  
Atiye ÇENGEL ◽  
Sedat TÜRKOǦU ◽  
Murat TURFAN ◽  
Bülent BOYACI
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Decompensated Heart Failure ◽  
Hospital Death
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