scholarly journals Independent associations of urine neutrophil gelatinase–associated lipocalin and serum uric acid with interstitial fibrosis and tubular atrophy in primary glomerulonephritis

2016 ◽  
pp. 111 ◽  
Author(s):  
Chagriya Kitiyakara ◽  
Amornpan Lertrit ◽  
Suchin Worawichawong ◽  
Somlak Vanavanan ◽  
Anchalee Chittamma ◽  
...  
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Interstitial Fibrosis ◽  
Tubular Atrophy ◽  
Primary Glomerulonephritis ◽  
Neutrophil Gelatinase

scholarly journals The Serum Uric Acid Level Is Related to the More Severe Renal Histopathology of Female IgA Nephropathy Patients

2021 ◽  
Vol 10 (9) ◽  
pp. 1885
Author(s):  
Won Jung Choi ◽  
Yu A Hong ◽  
Ji Won Min ◽  
Eun Sil Koh ◽  
Hyung Duk Kim ◽  
...  
Keyword(s):  
Uric Acid ◽  
Iga Nephropathy ◽  
Serum Uric Acid ◽  
Interstitial Fibrosis ◽  
Serum Uric Acid Level ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
University Hospitals ◽  
Tubular Atrophy ◽  
Matrix Expansion

Hyperuricemia is a significant risk factor for cardiovascular morbidity and chronic kidney disease progression. IgA nephropathy (IgAN) is a well-known primary glomerular nephropathy. Hyperuricemia is associated with a poor prognosis in IgAN patients. We evaluated the association of hyperuricemia with the histopathological severity of IgAN in male and female patients; 658 patients diagnosed with IgAN via kidney biopsy were initially included. Baseline patient data were collected by eight university hospitals affiliated with the College of Medicine of the Catholic University of Korea. Pathological features were independently evaluated by eight expert pathologists working in the hospitals, and the consensus was reached. Of the initial 658 patients, 517 were finally included (253 males and 264 females). Hyperuricemia was defined as a serum uric acid (UA) level >7.0 mg/dL for males and >5.6 mg/dL for females; 108 (42.7%) males and 95 (35.9%) females exhibited hyperuricemia. Compared to the patients with normal UA levels, the global glomerulosclerosis, segmental sclerosis, mesangial matrix expansion (MME), endocapillary proliferation (ECP), interstitial fibrosis (IF), and tubular atrophy (TA) scores were higher in hyperuricemic males and females. In multivariable linear regression, the serum UA level correlated significantly with the MME, ECP, IF, and TA scores of female IgAN patients only.

scholarly journals P0361THE PREDICTIVE VALUE OF SERUM URIC ACID IN PRIMARY GLOMERULONEPHRITIS PATIENTS: A 5-YEARS RENAL PROGNOSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mykola Kolesnyk ◽  
Natalia Stepanova ◽  
Lyudmyla Snisar ◽  
Larysa Lebid
Keyword(s):  
Uric Acid ◽  
Risk Factor ◽  
Serum Uric Acid ◽  
Independent Risk Factor ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Ckd Progression ◽  
Primary Glomerulonephritis ◽  
Renal Prognosis

Abstract Background and Aims Primary glomerulonephritis (PGN) is one of the leading causes of end-stage renal disease worldwide. Preservation of renal function is a crucial global goal in the management of patients with chronic kidney disease (CKD) in general and PGN in particular. In addition to classical risk factors, hyperuricemia is regarded to be an independent risk factor for CKD development and progression. However, only a few studies have investigated the impact of hyperuricemia on PGN progression. Therefore, this study aimed to analyze the association between serum uric acid (SUA) concentration and renal prognosis in PGN patients during a 5-year follow-up. Method A total of 344 patients with CKD 1-3 stages were included in this retrospective observational single-center study. Among them, there were 194 (56.4 %) patients with biopsy-proven PGN and 150 (43.6 %) patients with a clinical diagnosis of PGN. All patients were treated according to the KDIGO Practice Clinical Guidelines for Glomerulonephritis. eGFR (milliliters per minute per 1.73 m2) was calculated using the CKD-EPI formula and its baseline value was based on the first available eGFR in PGN diagnosed patients. The patients with eGFR< 30 mL//min/1.73 m2 were excluded from the study at the time of PGN diagnosis. None of the patients was on urate- or lipid-lowering therapy at the time of baseline data. Hyperuricemia was defined as SUA concentration ≥420 μmol/L (7 mg/dL) for males and ≥360 μmol/L (6 mg/dL) for females. The rate of eGFR fall per year was used to assess CKD progression. It was calculated as the difference between eGFR (mL/min/1.73m2) at baseline and the last values: (Last eGFR – Baseline eGFR) / Follow-up period per year). For the analysis, the patients were gender-stratified into 3 SUA quartiles according to average SUA levels at baseline: Q1- < 265 μmol/L for men and <220 μmol/L for women, Q2- 265-446 μmol/L for men and 220-369 μmol/L for women, Q3- ≥ 447 μmol/L for men and ≥ 370 for women. The analysis and all graphs were performed using MedCalc (Belgium). Results Hyperuricemia was found in 72/206 (35 %) men and 38/138 (27.5 %) women (p = 0.0003). During the average 5-years follow-up period (5.3 [3.8-6.2]), there were 114 (33.1%) patients who eventually progressed to eGFR<15 mL/min/1.73 m2 or started RRT. Among them there were: Q1- 10 (12%) patients, Q2 - 52 (31.5%) patients, Q3 - 52 (54.7%) patients (p< 0.0001). The highest renal progression level was observed in Q3 patients: -5.5 [-15.4; -1.8] mL/min/1.73 m2 versus -3.5 [-6.4; -1.7] and -4.6 [-10.6; -2.7] mL/min/1.73 m2 in Q2 and Q1 patients, respectively. In multivariate logistic regression analysis, SUA level in men (≥ 447 μmol/L) and women (≥ 370) was determined as an independent risk factor for rapid CKD progression (OR: 2.5, 95% CI: 1.47-4.23, P = 0.0007). Conclusion. Our study showed that a higher SUA level was associated with a significant rapid eGFR decline during a 5-year follow-up. The study findings suggest that hyperuricemia is a potentially modifiable factor for CKD progression.

Uric Acid as a Predictor of Immunoglobulin A Nephropathy Progression: A Cohort Study of 1965 Cases

2018 ◽  
Vol 48 (2) ◽  
pp. 127-136 ◽  
Author(s):  
Bin Zhu ◽  
Dong-rong Yu ◽  
Ji-cheng Lv ◽  
Yi Lin ◽  
Qiang Li ◽  
...  
Keyword(s):  
Uric Acid ◽  
Kidney Failure ◽  
Regression Models ◽  
Primary Outcome ◽  
Interstitial Fibrosis ◽  
Immunoglobulin A ◽  
Immunoglobulin A Nephropathy ◽  
Tubular Atrophy ◽  
Increased Risk ◽  
All Cause Mortality

Background: The role of serum uric acid (SUA) level in the progression of Immunoglobulin A nephropathy (IgAN) remains controversial. Methods: In a cohort of 1,965 cases with biopsy-proven IgAN, we examined the associations of SUA concentration with the primary outcome of a composite of all-cause mortality or kidney failure (defined as a reduction of estimated glomerular filtration rate [eGFR] by 40% from baseline, requirements for dialysis and transplantation), or the outcome of kidney failure alone, assessed using Cox and logistic regression models, respectively, with adjustment for confounders. Results: At baseline, the mean age was 33.37 ± 11.07 years, eGFR was 101.30 ± 30.49 mL/min/1.73 m2, and mean uric acid level was 5.32 ± 1.76 mg/dL. During a median of 7-year follow-up, 317 cases reached the composite outcome of all-cause mortality (5 deaths) or kidney failure (36 cases of dialysis, 5 cases of renal transplantation, and 271 cases with reduction of eGFR by 40% from baseline). After adjustment for demographic and IgAN specific covariates and treatments, a higher quartile of uric acid was linearly associated with an increased risk of the primary outcome (highest versus lowest quartile, hazard ratio [HR] 2.39; 95% CI 1.52–3.75) and kidney failure (highest versus lowest quartile, HR 2.55; 95% CI 1.62–4.01) in the Cox proportional hazards regression models. In the continuous analysis, a 1 mg/dL greater uric acid level was associated with 16% increased risk of primary outcome (HR 1.16, 95% CI 1.07–1.25) and 17% increased risk of kidney failure (HR 1.17, 95% CI 1.08–1.27), respectively, in the fully adjusted model. The multivariate ­logistic regression analyses for the sensitive analyses drew consistent results. In the subgroup analyses, significant interactions were detected that patients with mean arterial pressure (MAP) < 90 mm Hg or mesangial hypercellularity had a higher association of SUA with the incidence of the primary outcome than those with MAP ≥90 mm Hg or those without mesangial hypercellularity respectively. Hyperuricemia was not significantly associated with the risk of developing the primary outcome in elder patients (≥32 years old), patients with eGFR < 90 mL/min or with tubular atrophy/interstitial fibrosis. Conclusions: SUA level may be positively associated with the progression of IgAN. It was noticeable that the association of hyperuricemia with IgAN progression was less significant in patients with elder age, lower eGFR, or tubular atrophy/interstitial fibrosis, which may be due to some more confounders in association with the IgA progression in these patients. Future prospective studies are warranted to confirm these findings and to investigate the underlying mechanisms.

Uric Acid and Allograft Loss From Interstitial Fibrosis/Tubular Atrophy

2014 ◽  
Vol 97 (10) ◽  
pp. 1066-1071 ◽  
Author(s):  
Allyson Hart ◽  
Scott Jackson ◽  
Bertram L. Kasiske ◽  
Michael S. Mauer ◽  
Behzad Najafian ◽  
...  
Keyword(s):  
Uric Acid ◽  
Interstitial Fibrosis ◽  
Tubular Atrophy ◽  
Allograft Loss

scholarly journals Effects of Chicory on Serum Uric Acid, Renal Function, and GLUT9 Expression in Hyperuricaemic Rats with Renal Injury and In Vitro Verification with Cells

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Yong-Nan Jin ◽  
Zhi-Jian Lin ◽  
Bing Zhang ◽  
Yun-Fei Bai
Keyword(s):  
Renal Function ◽  
Uric Acid ◽  
Renal Dysfunction ◽  
Serum Uric Acid ◽  
Renal Injury ◽  
Interstitial Fibrosis ◽  
Serum Uric Acid Level ◽  
In Vivo Studies ◽  
Renal Tubules

Hyperuricaemia (HUA) is an independent risk factor for chronic kidney disease. Urate crystals are deposited in the kidney and can cause renal tubular interstitial fibrosis, leading to renal dysfunction. Chicory extract (hereafter referred to as chicory) clearly reduced serum uric acid levels in rats with HUA induced by 10% fructose. This is the first study to observe the effect of chicory on serum uric acid levels and renal function in rats with HUA and renal injury. In vivo studies using hyperuricaemic rats with renal injury induced by yeast and adenine demonstrated that chicory decreased serum uric acid level, and its effect of delaying the progression of kidney injury was better than that of benzbromarone. In vitro cell experiments showed that this effect is related to the inhibition of GLUT9 protein expression in renal tubules and that lowering blood uric acid concentrations is one of the factors that alleviates renal damage. The results of this study indicate that chicory can be used as an alternative for alleviating renal dysfunction in hyperuricaemia.

scholarly journals The Oxford Classification of IgA nephropathy: A review of literature

2018 ◽  
Vol 8 (1) ◽  
pp. 1308-1312
Author(s):  
Anil Dev Pant
Keyword(s):  
Iga Nephropathy ◽  
Interstitial Fibrosis ◽  
Asian Population ◽  
Oxford Classification ◽  
Tubular Atrophy ◽  
Mesangial Proliferation ◽  
Primary Glomerulonephritis ◽  
The World ◽  
The Oxford Classification

IgA nephropathy is one of the commonest forms of primary glomerulonephritis in the world, most commonly among Asian population.  Though usually slowly progressive, it is one of the important causes of chronic renal failure. Abnormal IgA1 are formed which leads to formation of IgG antibodies which deposit in the mesangium.  It presents with synpharyngitic hematuria and can have variable histopathological patterns.  The Oxford classification was devised in order to categorize the histopathological patterns, correlate with clinical course and modify treatment accordingly.  Different histopathological criteria are assessed in the classification, which include mesangial proliferation (M), endocapilary proliferation (E), segmental sclerosis (S), and interstitial fibrosis/tubular atrophy (T).The classification has become widely accepted around the world but still needs further validation studies and incorporation of newer parameters. 

scholarly journals Serum uric acid and renal survival prognosis in primary glomerulonephritis patients in a retrospective single-center cohort

2020 ◽  
Vol 10 (2) ◽  
pp. e11-e11
Author(s):  
Natalia Stepanova ◽  
Lyudmila Snisar ◽  
Larysa Lebid ◽  
Svitlana Savchenko ◽  
Valentyn Nepomnyashchii ◽  
...  
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Single Center ◽  
Renal Survival ◽  
Survival Prognosis ◽  
Primary Glomerulonephritis ◽  
Nephrotic Range Proteinuria ◽  
Annual Decline ◽  
Egfr Decline

Introduction: The role of serum uric acid (SUA) concentration in primary glomerulonephritis (PGN) aggravation is currently under active discussion. Objectives: This study primarily aimed to analyze the association between SUA concentration and renal survival prognosis in PGN patients and secondarily to determine whether hyperuricemia is an independent risk factor for reduced glomerular filtration rate (GFR) in the presence of nephrotic syndrome. Patients and Methods: We performed a retrospective observational single-center study involving 344 patients with biopsy-proved or clinically diagnosed PGN with the mean follow-up period of 5.3 [3.8-6.2] years. The rate of annual decline in estimated GFR (eGFR) was used to assess chronic kidney disease progression. Primary outcome measures were eGFR decline or transfer to renal replacement therapy (RRT) during the 5-year follow-up period. Results: There were 78/344 (22.7%) patients who eventually progressed to eGFR <15 mL/min/1.73 m2 or started RRT. In multivariate logistic regression analysis eGFR at diagnosis, proteinuria and hyperuricemia were associated with increased renal risk in PGN patients during the 5-year follow-up period. However, a less significant effect of SUA on rapid eGFR decline was found in the patients with nephrotic-range proteinuria compared with the patients with mild proteinuria. Conclusion: Our study revealed that a higher level of SUA was significantly associated with a greater annual decline in GFR and, consequently, a worse 5-year renal survival prognosis in PGN patients. The effect of hyperuricemia on the risk of rapid CKD progression was greater in PGN patients with mild proteinuria compared with the patients with nephrotic-range proteinuria.

scholarly journals Serum uric acid level is correlated with the clinical, pathological progression and prognosis of IgA nephropathy: an observational retrospective pilot-study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10130
Author(s):  
Pingfan Lu ◽  
Xiaoqing Li ◽  
Na Zhu ◽  
Yuanjun Deng ◽  
Yang Cai ◽  
...  
Keyword(s):  
Uric Acid ◽  
Iga Nephropathy ◽  
Serum Uric Acid ◽  
Interstitial Fibrosis ◽  
Serum Uric Acid Level ◽  
Immunoglobulin M ◽  
Complement C3 ◽  
Renal Outcome ◽  
Glomerular Sclerosis ◽  
Significant Difference

Objectives This study was aimed to assess the relationship between serum uric acid (SUA) level and the clinical, pathological phenotype of IgA nephropathy (IgAN), and to determine the role of SUA level in the progression and prognosis of IgAN. Methods A total of 208 patients with IgAN were included in this study, and were classified into the normo-uricemia group and hyperuricemia group according to the SUA level. The clinical data at baseline, IgAN Oxford classification scores (MEST-C scoring system), and other pathological features were collected and further analyzed. All patients were followed up and the prognosis was assessed using Kaplan-Meier survival curves. GraphPad Prism 7.0 and SPSS 23.0 were used for statistical analyses. Results In clinical indicators, patients with hyperuricemia had the significantly higher proportion of males to females, mean arterial pressure, the levels of total cholesterol, triglyceride, Scr, BUN, 24 hour-urine protein, C3, and C4, the lower levels of high-density lipoprotein cholesterol and eGFR than those without (p < 0.05). In terms of pathological characteristics, the tubular atrophy/interstitial fibrosis scores, vascular injury scores, and glomerular sclerosis percentage were significantly higher in patients with hyperuricemia compared with those without (p < 0.01). There was no significant difference in the scores of mesangial hypercellularity, endocapillary hypercellularity, focal segmental glomerulosclerosis, as well as crescents between the two groups (p > 0.05). As for the depositions of immune complexes deposition in IgAN, the hyperuricemia group had less deposition of immunoglobulin G and FRA than the normo-uricemia group (p < 0.05), while the deposition of immunoglobulin A, immunoglobulin M, and complement C3 in the two groups showed no statistical difference. The survival curve suggested that patients in the hyperuricemia group have significantly poorer renal outcome than those in the normo-uricemia group (p = 0.0147). Results also revealed that the SUA level is a valuable predictor of renal outcome in patients with IgAN. The optimal cutoff value was 361.1 µmol/L (AUC = 0.76 ± 0.08167) and 614 µmol/L (AUC = 0.5728 ± 0.2029) for female and male, respectively. Conclusions The level of SUA is associated with renal function level and pathological severity of IgAN, and maybe a prognostic indicator of IgAN.

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