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 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&lt; 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- &lt; 265 μmol/L for men and &lt;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&lt;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&lt; 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.

scholarly journals The effect of baseline serum uric acid on chronic kidney disease in normotensive, normoglycemic, and non-obese individuals: A health checkup cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244106
Author(s):  
Young-Bin Son ◽  
Ji Hyun Yang ◽  
Myung-Gyu Kim ◽  
Sang Kyung Jo ◽  
Won Yong Cho ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Risk Factor ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Independent Risk Factor ◽  
Baseline Serum ◽  
Increased Risk ◽  
Egfr Decline

Introduction The independent role of serum uric acid (SUA) on kidney disease is controversial due to its association with metabolic syndrome. The objective of this study was to investigate the association of baseline SUA with development of chronic kidney disease and eGFR decline in normotensive, normoglycemic and non-obese individuals during follow up period. Materials and methods We included non-hypertensitive, non-diabetic, and non-obese 13,133 adults with estimated glomerular filtration rate (eGFR) ≥ 60ml/min/1.73m2 who had a voluntary health check-up during 2004–2017. Results SUA was positively related to adjusted means of systolic blood pressure (SBP), triglyceride, body mass index, and body fat percent. SUA was inversely associated with high density lipoprotein HDL (P for trend ≤0.001). SUA was an independent risk factor for the development of diabetes, hypertension, and obesity. During 45.0 [24.0–76.0] months of median follow up, the highest quartiles of SUA showed significant risks of 30% eGFR decline compared than the lowest quartile (RR:3.701; 95% CI: 1.504–9.108). The highest quartile had a 2.2 fold (95% CI: 1.182–4.177) increase in risk for incident chronic kidney disease (CKD). Conclusions SUA is an independent risk factor for the development of diabetes, hypertension, and obesity in the healthy population. High SUA is associated with increased risk of CKD development and eGFR decline in participants with intact renal function.

scholarly journals Serum uric acid is associated with damage in patients with systemic lupus erythematosus

2020 ◽  
Vol 7 (1) ◽  
pp. e000366 ◽  
Author(s):  
Claudia Elera-Fitzcarrald ◽  
Cristina Reátegui-Sokolova ◽  
Rocio Violeta Gamboa-Cardenas ◽  
Mariela Medina ◽  
Francisco Zevallos ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Lupus Erythematosus ◽  
Cox Regression ◽  
Activity Index ◽  
Damage Index ◽  
Systemic Lupus ◽  
The Impact

IntroductionSerum uric acid levels have been reported as predictors of cardiovascular, pulmonary, neurological and renal morbidity in patients with SLE. However, their role in cumulative global damage in these patients has not yet been determined.ObjectiveTo determine whether serum uric acid levels are associated with new damage in patients with SLE.MethodsThis is a longitudinal study of patients with SLE from the Almenara Lupus Cohort, which began in 2012. At each visit, demographic and clinical characteristics were evaluated, such as activity (Systemic Lupus Erythematosus Disease Activity Index-2K or SLEDAI-2K) and cumulative damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index or SDI). Treatment (glucocorticoids, immunosuppressive drugs and antimalarials) was also recorded. Univariable and multivariable Cox regression models were used to determine the impact of serum uric acid levels on the risk of new damage.ResultsWe evaluated 237 patients, with a mean age (SD) at diagnosis of 35.9 (13.1) years; 220 patients (92.8%) were women, and the duration of the disease was 7.3 (6.6) years. The mean SLEDAI-2K and SDI scores were 5.1 (4.2) and 0.9 (1.3), respectively. Serum uric acid level was 4.5 (1.4) mg/dL. Follow-up time was 3.1 (1.3) years, and 112 (47.3%) patients accrued damage during follow-up. In univariable and multivariable analyses, serum uric acid levels were associated with new damage (HR=1.141 (95% CI 1.016 to 1.282), p=0.026; HR=1.189 (95% CI 1.025 to 1.378), p=0.022, respectively).ConclusionHigher serum uric acid levels are associated with global damage in patients with SLE.

scholarly journals Effect of Allopurinol on Inflammatory Markers in Chronic Kidney Disease Patients with Asymptomatic Hyperuricaemia

2017 ◽  
Vol 26 (1) ◽  
pp. 12-24
Author(s):  
ASM Tanim Anwar ◽  
Md Nizamuddin Chowdhury ◽  
Md Nazrul Islam ◽  
Parvez Iftekher Ahmed ◽  
Sohely Ahmed Sweety ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Treatment Group ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Control Group ◽  
Base Line

This was a hospital based prospective, interventional study which included CKD stage 3- 5 patients with higher level of uric acid (male>7mg/dl, female>6mg/dl). The objective of the study was to evaluate the effect of allopurinol on inflammatory markers in patients with chronic kidney disease (stage 3-5) with asymptomatic hyperuricaemia. One hundred and twenty patients were distributed in two groups. Sixty patients were placed in treatment group and sixty in control group. Purposive sampling technique was followed. In the study mean age was 49 (±9) years in treatment group and 45 (±11) years in control groups. Male were predominant in both groups. There were no significant difference in baseline characteristics between treatment group and control group (p>0.05). Sixty patients of treatment group were administered a dose of 100 mg/d of allopurinol. Follow up assessment was done at basally, at 4 months and at 8 month after starting treatment. No significant differences were seen between baseline SBP, DBP, Hb and HbA1c with 4th month and 8th month follow up in both treatment group and control group, but mean Hb was significantly decreased in control group from the baseline after 8 month. No significant change was found in case of mean ESR at 4th and 8th month in any group. But base line mean CRP was significantly reduced in treatment group and increased in control group at 4th and 8th month of follow up. Serum uric acid was decreased in treatment group while it was significantly raised from the base line at 4th month and 8th month in control group. While comparing between two groups results showed means of serum uric acid and CRP were significantly decreased in treatment group compared to control group after 8th month. There was a positive correlation between Uric Acid with CRP level after 8 month of allopurinol treatment although this finding was not statistically significant. So, allopurinol may have a protective role in CKD by decreasing serum uric acid level and reduction of inflammatory response in patients with chronic kidney disease stage 3 - 5 with asymptomatic hyperuricaemia.J Dhaka Medical College, Vol. 26, No.1, April, 2017, Page 12-24

Lower serum uric acid is associated with mild cognitive impairment in early Parkinson’s disease: a 4-year follow-up study

2016 ◽  
Vol 123 (12) ◽  
pp. 1399-1402 ◽  
Author(s):  
Maria Teresa Pellecchia ◽  
Riccardo Savastano ◽  
Marcello Moccia ◽  
Marina Picillo ◽  
Pietro Siano ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Uric Acid ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Serum Uric Acid ◽  
Lower Serum ◽  
Follow Up Study ◽  
Early Parkinson’S Disease

scholarly journals Effect of Allopurinol in Chronic Kidney Disease Progression in Asymptomatic Hyperuricaemic Subjects

2017 ◽  
Vol 25 (1) ◽  
pp. 5-15
Author(s):  
ASM Tanim Anwar ◽  
Md Nizamuddin Chowdhury ◽  
Md Nazrul Islam ◽  
Parvez Iftekher Ahmed ◽  
Sohely Ahmed Sweety ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Treatment Group ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Control Group ◽  
And Control

This was a hospital based prospective, interventional study which included CKD stage 3- 5 patients with higher level of uric acid (male>7mg/dl, female>6mg/dl). The objective of the study was to evaluate the effect of allopurinol in chronic kidney disease (stage 3-5) progression in asymptomatic hyperuricaemic patients.One hundred and twenty patients were distributed in two groups. Sixty patients were placed in treatment group and sixty in control group. Purposive sampling technique was followed. In the study mean age was 49 (±9) years in treatment group and 45 (±11) years in control groups. Male were predominant in both groups. There were no significant difference in baseline characteristics between treatment group and control group (p>0.05). Sixty patients of treatment group were administered a dose of 100 mg/d of allopurinol. Follow up assessment was done at basally, at 4 months and at 8 month after starting treatment. No significant differences were seen between baseline SBP, DBP, Hb and HbA1c with 4th month and 8th month follow up in both treatment group and control group, but mean Hb was significantly decreased in control group from the baseline after 8 month. Serum uric acid was decreased in treatment group while it was significantly raised from the base line at 4th month and 8th month in control group. In treatment group serum creatinine was decreased and eGFR was raised from the baseline after 8 month. On the other hand, in control group serum creatinine was significantly raised and eGFR was significantly decreased from the baseline at 8th month. While comparing between two groups results showed means of serum uric acid was significantly decreased in treatment group compared to control group after 8th month. There was a negative correlation between Uric Acid with eGFR after 8 month of allopurinol treatment although this finding was not statistically significant. So, allopurinol may have a protective role in CKD progression by decreasing serum uric acid level in patients with chronic kidney disease stage 3 - 5 with asymptomatic hyperuricaemia.J Dhaka Medical College, Vol. 25, No.1, April, 2016, Page 5-15

scholarly journals The Significance of Follow-Up Serum Uric Acid Levels in Predicting All-Cause Mortality and Cardiovascular Mortality in Peritoneal Dialysis Patients

2021 ◽  
Author(s):  
Pingping Ren ◽  
Qilong Zhang ◽  
Yixuan Pan ◽  
Yi Liu ◽  
Chenglin Li ◽  
...  
Keyword(s):  
Uric Acid ◽  
Peritoneal Dialysis ◽  
Serum Uric Acid ◽  
Cardiovascular Mortality ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Kaplan Meier ◽  
Significant Difference ◽  
All Cause Mortality

Abstract Background: Studies on the correlation between serum uric acid (SUA) and all-cause mortality in peritoneal dialysis (PD) patients were mainly based on the results of baseline SUA. We aimed to analyze the change of SUA level post PD, and the correlation between follow-up SUA and prognosis in PD patients. Methods: All patients who received PD catheterization and maintaining PD in our center from March 2, 2001 to March 8, 2017 were screened. Kaplan-Meier and Cox proportional-hazards regression models were used to analyze the effect of SUA levels on the risks of death. We graded SUA levels at baseline, 6 months, 12 months, 18 months and 24 months post PD by mean of SUA plus or minus a standard deviation as cut-off values, and compared all-cause and cardiovascular mortality among patients with different SUA grades. Results: A total of 1402 patients were included, 763 males (54.42%) and 639 females (45.58%). Their average age at PD start was 49.50±14.20 years. The SUA levels were 7.97±1.79mg/dl at baseline, 7.12±1.48mg/dl at 6 months, 7.05±1.33mg/dl at 12 months, 7.01±1.30mg/dl at 18 months, and 6.93±1.26mg/dl at 24 months. During median follow-up time of 31 (18, 49) months, 173 (12.34%) all-cause deaths occurred, including 68 (4.85%) cardiovascular deaths. There were no significant differences on all-cause mortality among groups with graded SUA levels at baseline, 12 months, 18 months and 24 months during follow-up or on cardiovascular mortality among groups with graded SUA levels at baseline, 6 months, 12 months, 18 months and 24 months during follow-up. At 6 months post PD，Kaplan Meier analysis showed there was significant difference on all-cause mortality among graded SUA levels (c2=11.315, P=0.010), and the all-cause mortality was lowest in grade of 5.65mg/dl≤SUA<7.13mg/dl. Conclusion: SUA level decreased during follow up post PD. At 6 months post PD, a grade of 5.65mg/dl≤SUA<7.13mg/dl was appropriate for better patients’ survival.

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