Renal disease from excess uric acid

In vitro and in vivo Uric Acid Lowering by Artificial Cells Containing Microencapsulated Genetically Engineered E. coli DH5 Cells

Increase in systemic uric acid occurs in renal insufficiency, gout, chemotherapy, and other diseases. Dialysis can lower this metabolite but is expensive. The use of drugs can, sometime, result in side effects. Therefore, a suitable affordable method for this is required. In this article, for the first time, we report the use of artificial cells containing micro encapsulated genetically engineered E. Coli DH5 cells for lowering uric acid in vitro and in vivo. Results show that this novel approach has the ability to significantly lower uric acid from 84.80±3.40 mg/dl to 9.32±0.05 mg/dl in vitro and from the plasma of the experimental animals from the control levels of 71.00±27.49 mg/dl to 20.33+17.92 mg/dl in vivo. Continued daily oral administration maintained the plasma uric acid concentration of experimental uremic rats to the normal plasma uric acid level range during the entire test period.

Acute uric acid nephropathy

Uric acid, as the end-product of purine metabolism in humans, presents a clinical problem because of its relative insolubility, particularly in the acid environment of the distal nephron of the kidney. As a result, states of enhanced purine catabolism increase the urate load on the kidney, leading to intrarenal precipitation. Major causes of increased purine metabolism are malignancies with rapid cell turnover, such as leukemias and lymphomas, and the added acceleration of cell lysis that occurs with chemotherapy and radiation. Serum urate levels rise rapidly, and acute renal failure occurs as a consequence of tubular deposition of urate and uric acid. The keys to the diagnosis of acute uric acid nephropathy are the appropriate clinical setting of increased cell lysis, oliguria, marked hyperuricemia, and hyperuricosuria. A urinary uric acid-to-creatinine ratio greater than 1 helps to distinguish acute uric acid nephropathy from other catabolic forms of acute renal failure in which serum urate is elevated. Preventive treatment involves pharmacologic xanthine oxidase inhibition with allopurinol and alkaline diuresis. Occasionally, acute renal failure occurs despite allopurinol because of the tubular precipitation of the precursor metabolites, such as xanthine, which accumulate with xanthine oxidase inhibition. Dialysis therapy may be required both to correct azotemia and to reduce the body burden of urate. Hemodialysis is preferred because it can achieve greater clearance than other dialysis modes.