Hypertensive renal vascular disease and cardiovascular endpoints

The effect of erythropoietin on serum uric acid levels during renal ischemia reperfusion injury in rats

OBJECTIVE

The aim of this experimental study was to assess the effect of erythropoietin on a rat model, particularly under a renal ischemia reperfusion protocol. The beneficial or lack of effects of that molecule on the excreted renal product of serum uric acid were studied biochemically.

MATERIAL AND METHODS

Forty rats were used with a mean weight of 247.7 gr. Serum uric acid levels were measured measured at 60 min after reperfusion (Groups A and C) and at 120 min after reperfusion (groups B and D).

RESULTS

1) Erythropoietin administration non-significantly decreased the serum uric acid levels non-significantly by 0.02 mg/dL [-0.2415423 mg/dL-0.2015423 mg/dL] (p=0.8560), in accordance with the paired t-test (p=0.8438). Reperfusion time non-significantly increased the serum uric acid levels non-significantly by 0.17 mg/dL [-0.0444933 mg/dL-0.3844933 mg/dL] (p=0.1169), in accordance with the paired t-test (p=0.1648). 3) The interaction of erythropoietin administration and reperfusion time non-significantly increased the serum uric acid levels non-significantly by 0.1 mg/dL [-0.0295564 mg/dL-0.2295564 mg/dL] (p=0.1264).

CONCLUSION

Erythropoietin administration, reperfusion time and their interaction have no significant short-term alterations on serum uric acid levels. Conclusions cannot be extracted by non-significant p-values within 2 hours. Obviously, longer study times may permit safer results.

Making a case for quantitative assessment of cardiovascular risk

Cardiovascular disease (CVD) causes nearly one third of all deaths worldwide. Estimates of the cumulative effects of the most common cardiovascular risk factors indicate that >30% of the chronic care burden of CVD and >50% of deaths from CVD are attributable to modifiable risk factors, such as cigarette smoking, elevated low-density lipoprotein cholesterol, low levels of high-density lipoprotein cholesterol, diabetes mellitus, and hypertension. While a significant percentage of patients present with one or more of these risk factors, health care practitioners encounter great difficulty in achieving long-term patient adherence to risk-factor modification interventions. More accurate stratification of death and disability risk across age, gender, and ethnic categories-and more comprehensible quantification of the magnitude and timeframe of the impact of risk-factor modification on such risks-will likely be useful to patients and health care practitioners in the implementation of more effective strategies. There is a need to study which risk-assessment methodologies, which depictions of short- and long-term risk, and which intervention modalities will have the greatest possible impact on patients' understanding of risk factors and risk-modification behaviors.

Cardiac hypertrophy and fibrosis in the metabolic syndrome: a role for aldosterone and the mineralocorticoid receptor

Obesity and hypertension, major risk factors for the metabolic syndrome, render individuals susceptible to an increased risk of cardiovascular complications, such as adverse cardiac remodeling and heart failure. There has been much investigation into the role that an increase in the renin-angiotensin-aldosterone system (RAAS) plays in the pathogenesis of metabolic syndrome and in particular, how aldosterone mediates left ventricular hypertrophy and increased cardiac fibrosis via its interaction with the mineralocorticoid receptor (MR). Here, we review the pertinent findings that link obesity with elevated aldosterone and the development of cardiac hypertrophy and fibrosis associated with the metabolic syndrome. These studies illustrate a complex cross-talk between adipose tissue, the heart, and the adrenal cortex. Furthermore, we discuss findings from our laboratory that suggest that cardiac hypertrophy and fibrosis in the metabolic syndrome may involve cross-talk between aldosterone and adipokines (such as adiponectin).