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Pop C, Gheorghe Fronea OF, Branea IA, Itu LM, Darabont R, Parepa I, Benedek T, Dorobantu M. Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey. Diagnostics (Basel) 2022; 12:3199. [PMID: 36553206 PMCID: PMC9777169 DOI: 10.3390/diagnostics12123199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/09/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022] Open
Abstract
Background: The prevalence of chronic kidney disease (CKD) correlates with the prevalence of hypertension (HT). We studied the prevalence and predictors of CKD in a representative sample of the Romanian adult population. Methods: A sample of 1470 subjects were enrolled in the SEPHAR IV (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk) survey. All subjects were evaluated for blood pressure (BP) and extensive evaluations of target organ damage, blood, and urine samples were undertaken. Results: A total of 883 subjects were included in the statistical analysis. Those experiencing CKD with an eGFR < 60 mL/min/1.73 m2 were older at 71.94 ± 7.4 years (n = 19, 2.15%) compared with those without renal impairment at 50.3 ± 16.21 years (n = 864, 97.85%), p < 0.0001. The prevalence of CKD among hypertensives (379 from 883) was 4.49% (17/379), while 17 out of 19 subjects with CKD had HT (89.47%). After adjusting for age, sex, and diabetic status, only serum uric acid (SUR) > 6.9 mg/dL (OR: 6.61; 95% CI: 2.063, 10.83; p = 0.004) was an independent risk factor and a predictor of CKD. Conclusions: The prevalence of CKD in hypertensive Romanian adults was more than ten times higher than in the normotensive population. Levels of SUR > 6.9 mg/dL were predictors of CKD.
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Affiliation(s)
- Călin Pop
- Emergency Clinical County Hospital of Baia Mare, 430130 Baia Mare, Romania
- Faculty of Medicine Arad, Str. Feleacului nr. 1, 310414 Arad, Romania
| | - Oana Florentina Gheorghe Fronea
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, Bulevardul Eroii Sanitari nr. 8, Sector 5, 050474 Bucuresti, Romania
- Cardiology Department, Clinical Emergency Hospital Bucharest, Bulevardul Eroii Sanitari nr. 8, Sector 5, 014461 Bucuresti, Romania
| | - Ioana Antonia Branea
- Department of Mathematics and Computer Science, Transilvania University of Brasov, B-dul Eroilor nr. 29, 500036 Brașov, Romania
| | - Lucian Mihai Itu
- Department of Automation and Information Technology, Transilvania University of Brasov, B-dul Eroilor nr. 29, 500036 Brașov, Romania
| | - Roxana Darabont
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, Bulevardul Eroii Sanitari nr. 8, Sector 5, 050474 Bucuresti, Romania
| | - Irinel Parepa
- “Ovidius” State University Constanta, Faculty of Medicine, Cardiology Dept, Campus Aleea Universitatii nr. 1, 900470 Constanta, Romania
| | - Theodora Benedek
- Cardiology Department, County Clinical Emergency Hospital, University of Medicine and Pharmacy, Street Gh. Marinescu, 38, 540142 Targu Mures, Romania
| | - Maria Dorobantu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, Bulevardul Eroii Sanitari nr. 8, Sector 5, 050474 Bucuresti, Romania
- Cardiology Department, Clinical Emergency Hospital Bucharest, Bulevardul Eroii Sanitari nr. 8, Sector 5, 014461 Bucuresti, Romania
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Jiang Z, Cao J, Su H, Cao H, Sun Z, Jiang H, Fan Y. Exercise serum regulates uric acid transporters in normal rat kidney cells. Sci Rep 2022; 12:18086. [PMID: 36302802 PMCID: PMC9613886 DOI: 10.1038/s41598-022-22570-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/17/2022] [Indexed: 12/30/2022] Open
Abstract
Hyperuricemia (HUA) refers to a physiological condition of high serum uric acid (SUA) level in the body, which may cause an increased risk of several chronic diseases. The kidney's impaired uric acid (UA) metabolism is an important reason for HUA. In this study, we tested the hypothesis that circulating factors produced during exercise regulate the expression of ABCC4, ABCG2, URAT1, and GLUT9 in normal rat kidneys and normal rat kidney cells (NRK-52E) and their relationship with NF-κB and NRF-2. NRK-52E cells were separately cultured by serum from 10 healthy SD rats who did not exercise (CON) and 10 healthy SD rats who did aerobic treadmill exercise for 6 weeks. Cells cultured by serum from rats who did aerobic treadmill exercise for 6 weeks were separated by without NRF-2 inhibitor (EXE) and with NRF-2 inhibitor (EXE + ML). SUA level of rats was tested by using dry chemical assays, xanthine oxidase (XOD) activity in serum and liver were tested by using enzyme colorimetry assays, protein expression in kidney and NRK-52E cells were tested by using Western-blot, and UA levels in the upper or lower chamber were tested by colorimetry assays. Aerobic exercise reduced SUA levels in rats but did not significantly affect on liver xanthine oxidase. It also increased the expression of some UA transporters in the kidney and NRK-52E cells and increased the cells' ability in UA excretion. When the NRF-2 was inhibited, the NF-κB and ABCG2 increased, and the expression of ABCC4, URAT1, and GLUT9 decreased. In conclusion, this study suggested that 6 weeks of aerobic treadmill exercise intervention may help to improve the excretion of UA in renal cells, suggesting that long-term aerobic exercise may be a means to prevent hyperuricemia.
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Affiliation(s)
- Zhongye Jiang
- grid.411614.70000 0001 2223 5394Sport Biochemistry Department, Sport Science College, Beijing Sport University, Beijing, China
| | - Jianmin Cao
- grid.411614.70000 0001 2223 5394Sport Biochemistry Department, Sport Science College, Beijing Sport University, Beijing, China
| | - Hao Su
- grid.411614.70000 0001 2223 5394Sport Biochemistry Department, Sport Science College, Beijing Sport University, Beijing, China
| | - Hui Cao
- grid.261049.80000 0004 0645 4572North China Electric Power University, Beijing, China
| | - Zeyuan Sun
- grid.411614.70000 0001 2223 5394Sport Biochemistry Department, Sport Science College, Beijing Sport University, Beijing, China
| | - Haoze Jiang
- grid.411614.70000 0001 2223 5394Sport Biochemistry Department, Sport Science College, Beijing Sport University, Beijing, China
| | - Yanjun Fan
- grid.411614.70000 0001 2223 5394Sport Biochemistry Department, Sport Science College, Beijing Sport University, Beijing, China
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Shen J, Zhu J, Si S, Fu Y, Mo M, Xin X, Shao B, Shen Y, Wang S, Wu H, Yu Y. Uric acid fluctuation had no effect on renal function among gout patients. Nutr Metab Cardiovasc Dis 2020; 30:1833-1839. [PMID: 32675011 DOI: 10.1016/j.numecd.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 05/12/2020] [Accepted: 06/11/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS To investigate the effects of serum uric acid (SUA) level and its fluctuation on renal dysfunction in gout patients. METHODS AND RESULTS Data on gout patients was collected from Huzhou city electronic medical record system data sharing platform, and information about relevant diagnoses, prescriptions, biochemical indexes and imaging characteristics was extracted. The gout patients with baseline normal renal function were enrolled in this analysis, and the estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 was defined as renal dysfunction. The generalized estimating equation and Cox regression analysis were used. A total of 1009 patients with gout were enrolled. Compared with the reference group (normal baseline SUA with endpoint SUA to be < 6 mg/dL), endpoint SUA ≥ 10 mg/dL was associated with an increased risk of renal dysfunction (baseline normal SUA group: HR [95% CI] = 3.28 [1.21, 8.91]; baseline high SUA group: HR [95% CI] = 3.01 [1.43, 6.35]). Subgroup analysis of 771 SUA stable gout patients demonstrated that SUA levels at 8-10 (excluding 10), and ≥10 mg/dL were significantly associated with an increased risk for renal dysfunction, with HR [95%CI] to be 1.99 [1.05, 3.77], and 2.98 [1.38, 6.43], respectively. CONCLUSION Regardless of the baseline SUA level, SUA >10 mg/dL was a significant risk factor for renal dysfunction. SUA between 6 and 10 mg/dL was a potential risk factor for renal dysfunction. No significant correlation of SUA fluctuation and renal function was found.
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Affiliation(s)
- Jianyong Shen
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Jianing Zhu
- Department of Public Health, and Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Shuting Si
- Department of Public Health, and Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yun Fu
- Huzhou Center for Disease Control and Prevention, Huzhou, China
| | - Minjia Mo
- Department of Public Health, and Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Xing Xin
- Department of Public Health, and Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Bule Shao
- Department of Public Health, and Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yu Shen
- Department of Public Health, and Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Shuojia Wang
- Department of Public Health, and Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Huaxiang Wu
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
| | - Yunxian Yu
- Department of Public Health, and Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
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Valente FM, de Andrade DO, Cosenso-Martin LN, Cesarino CB, Guimarães SM, Guimarães VB, Lacchini R, Tanus-Santos JE, Yugar-Toledo JC, Vilela-Martin JF. Plasma levels of matrix metalloproteinase-9 are elevated in individuals with hypertensive crisis. BMC Cardiovasc Disord 2020; 20:132. [PMID: 32164582 PMCID: PMC7066730 DOI: 10.1186/s12872-020-01412-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 03/02/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Matrix metalloproteinase-9 (MMP-9) participates in the degradation of components of the extracellular matrix and it is involved in vascular remodeling and vasomotor changes. The aim of this study was to investigate the plasma levels of MMP-9 in acute vascular alterations due to hypertensive crisis. METHODS This cross-sectional study was performed in 40 normotensive (NT) and 58 controlled hypertensive subjects (CHyp) followed up in outpatient clinic. Moreover, 57 patients with hypertensive emergency (HypEmerg) and 43 in hypertensive urgency (HypUrg), seen in emergency department, were also included. Hypertensive crisis was divided into HypEmerg, which was characterized by levels of systolic blood pressure (BP) ≥ 180 mmHg and/or diastolic BP ≥ 120 mmHg complicated with target-organ damage (TOD), and HypUrg, defined by BP elevation without TOD. Univariate and multivariate regression analysis was performed to identify the influence of independent variables on MMP-9 levels. A p-value < 0.05 was considered statistically significant. RESULTS The mean age was 43.5 years in the NT group (11 men); 57.7 years in the CHyp group (29 men); 59.4 years in the HypUrg group (21 men) and 62.4 years in the HypEmerg group (31 men). The age was statistically different in the NT group compared to other 3 groups. The mean BP was 116.5 ± 13.9/72.4 ± 10.6 mmHg for NT, 123.2 ± 12.6/79 ± 9.2 for CHyp, 194.1 ± 24.3/121.4 ± 17.3 for HypUrg and 191.6 ± 34.3/121.7 ± 18.8 mmHg for HypEmerg, respectively (p-value< 0.0001 between groups). MMP-9 levels were statistically different between the HypEmerg (2.31 ± 0.2 ng/mL) and HypUrg groups (2.17 ± 0.3 ng/mL) compared to the NT (1.94 ± 0.3 ng/mL) (p-value < 0.01 and p-value < 0.05, respectively) and CHyp groups (1.92 ± 0.2 ng/mL) (p-value < 0.01). Uric acid was the only independent variable for predicting MMP-9 levels (p-value = 0.001). CONCLUSION MMP-9 concentrations are significantly higher in the hypertensive crisis groups (urgency and emergency) compared to the control groups. Therefore, MMP-9 may be a biomarker or mediator of pathophysiologic pathways in cases of acute elevations of blood pressure.
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Affiliation(s)
- Flavia Mariana Valente
- Internal Medicine Department, Hypertension Clinic, State Medical School at Sao Jose do Rio Preto (FAMERP), Ave Brig Faria Lima, 5416, Sao Jose do Rio Preto, SP, 15090-000, Brazil
| | - Days Oliveira de Andrade
- Internal Medicine Department, Hypertension Clinic, State Medical School at Sao Jose do Rio Preto (FAMERP), Ave Brig Faria Lima, 5416, Sao Jose do Rio Preto, SP, 15090-000, Brazil
| | - Luciana Neves Cosenso-Martin
- Internal Medicine Department, Hypertension Clinic, State Medical School at Sao Jose do Rio Preto (FAMERP), Ave Brig Faria Lima, 5416, Sao Jose do Rio Preto, SP, 15090-000, Brazil
| | - Cláudia Bernardi Cesarino
- Internal Medicine Department, Hypertension Clinic, State Medical School at Sao Jose do Rio Preto (FAMERP), Ave Brig Faria Lima, 5416, Sao Jose do Rio Preto, SP, 15090-000, Brazil
| | - Sérgio Mussi Guimarães
- Internal Medicine Department, Hypertension Clinic, State Medical School at Sao Jose do Rio Preto (FAMERP), Ave Brig Faria Lima, 5416, Sao Jose do Rio Preto, SP, 15090-000, Brazil
| | | | - Riccardo Lacchini
- Department of Psychiatric Nursing and Human Sciences, Ribeirao Preto College of Nursing, University of Sao Paulo, R. Prof. Helio Lourenço, Ribeirao Preto, SP, 3900, Brazil
| | - José Eduardo Tanus-Santos
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ave Bandeirantes, Ribeirao Preto, SP, 3900, Brazil
| | - Juan Carlos Yugar-Toledo
- Internal Medicine Department, Hypertension Clinic, State Medical School at Sao Jose do Rio Preto (FAMERP), Ave Brig Faria Lima, 5416, Sao Jose do Rio Preto, SP, 15090-000, Brazil
| | - José Fernando Vilela-Martin
- Internal Medicine Department, Hypertension Clinic, State Medical School at Sao Jose do Rio Preto (FAMERP), Ave Brig Faria Lima, 5416, Sao Jose do Rio Preto, SP, 15090-000, Brazil.
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5
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Higa S, Shima D, Tomitani N, Fujimoto Y, Kario K. The effects of topiroxostat on vascular function in patients with hyperuricemia. J Clin Hypertens (Greenwich) 2019; 21:1713-1720. [PMID: 31556223 PMCID: PMC8030428 DOI: 10.1111/jch.13707] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/26/2019] [Accepted: 07/08/2019] [Indexed: 12/30/2022]
Abstract
Xanthine oxidoreductase (XOR) inhibitors, such as allopurinol and febuxostat, inhibit the catalysis of serum uric acid (SUA) synthesis. In doing so, they are thought to improve vascular endothelial function in patients with hyperuricemia and cardiovascular risk by reducing increases in SUA and reactive oxygen species levels. We performed a retrospective cohort study to evaluate the effects of topiroxostat, a novel XOR inhibitor, on vascular function measured by flow-mediated dilation (FMD) on ultrasonography. In total, 23 patients with hyperuricemia were enrolled. After approximately 8 weeks, topiroxostat was associated with a significant increase in the peak percentage change in diameter (∆FMD) from 4.53% ± 2.09% to 5.54% ± 3.08% (P = .045). It also significantly reduced the SUA levels from 7.31 ± 1.43 to 5.44 ± 1.11 mg/dL (P < .001). Although further studies are needed to validate these results, it appears that topiroxostat improves vascular endothelial function in patients with hyperuricemia.
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Affiliation(s)
| | | | | | | | - Kazuomi Kario
- Jichi Medical University School of MedicineTochigiJapan
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6
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Chronological renal resistive index increases related to atherosclerotic factors, and effect of renin-angiotensin system inhibitors. Clin Exp Nephrol 2018; 23:513-520. [PMID: 30426291 DOI: 10.1007/s10157-018-1667-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 10/30/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Renal resistive index (RI) calculated using renal Doppler ultrasonography (RDU) has recently been considered a clinically important indicator of renal outcome, survival, and systemic arteriosclerotic disorders. However, the cause of RI elevation remains unclear. The present study was an effort to first, identify the factors related to RI elevation, and second, understand the effect of renin-angiotensin system inhibitors (RAS-Is) on renal RI elevation. METHODS We carried out this single-center case-control study among 100 CKD patients, recruited from outpatients who underwent RDU more than twice, at least a year apart. The rate of renal RI change per year (dRIpy) was chosen as the dependent variable: [(last examined renal RI-initial examined renal RI)/(initial examined renal RI × period of observation) × 100 (%/year)]. We examined the association between dRIpy and other clinical and biological data. RESULTS Among 100 CKD patients, the average serum creatinine and eGFR were 1.76 ± 0.84 mg/dL and 37.0 ± 18.2 ml/min/1.73 m2, respectively. The average dRIpy in all patients was 1.8 ± 1.4%/year. The linear multiple regression demonstrated that dRIpy was positively associated with the presence of diabetes mellitus (DM) and high low-density lipoprotein cholesterol (LDL) levels, and negatively with eGFR and RAS-I use. CONCLUSIONS This study demonstrated that the elevation of RI was related to DM, eGFR, high LDL, and the use of RAS-Is. In particular, RAS-Is could contribute towards suppressing the elevation of RI in CKD patients and towards preventing the development of renal failure in CKD patients.
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Geraci G, Zammuto MM, Mattina A, Zanoli L, Geraci C, Granata A, Nardi E, Fatuzzo PM, Cottone S, Mulè G. Para-perirenal distribution of body fat is associated with reduced glomerular filtration rate regardless of other indices of adiposity in hypertensive patients. J Clin Hypertens (Greenwich) 2018; 20:1438-1446. [PMID: 30218482 DOI: 10.1111/jch.13366] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/07/2018] [Accepted: 07/23/2018] [Indexed: 12/14/2022]
Abstract
Obesity is a well-known risk factor for the development and progression of chronic kidney disease. Recently, para-perirenal ultrasonographic fat thickness (PUFT) has shown to correlate with both total and visceral fat better than body mass index (BMI), waist circumference (WC), and other indices of obesity. Moreover, a local paracrine and mechanical action of the PUFT on kidney has been described in recent studies. Aim of our study was to assess the relationship between glomerular filtration rate (GFR) and PUFT in comparison with other anthropometric and ultrasonographic indices of adiposity. Two hundred and ninety-six hypertensive patients were enrolled. PUFT, cutis-rectis thickness and rectis-aorta thickness were obtained by ultrasonography. Anthropometric measures of adiposity were also measured. Estimated GFR was calculated using the CKD-EPI equation. Higher PUFT values were observed in patients with impaired renal function (P < 0.001), whereas no differences in BMI and WC were shown between groups divided by GFR. PUFT significantly correlated with GFR in all patients (r = -0.284; P < 0.001), with no differences in groups divided by sex, diabetes, or BMI. This association held in multivariate analyses also after correction for confounding factors, including other adiposity indices (P < 0.001). When receiver operating characteristic curves were built to detect a eGFR < 60 mL/minutes per 1.73 m2 , a PUFT value ≤3.725 cm showed a negative predictive value of 94.0%, with the largest area under the curve (AUC: 0.700) among the variables considered. In conclusion, the relationship between PUFT and GFR seems to be more accurate and less influenced by the bias affecting traditional indices of adiposity.
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Affiliation(s)
- Giulio Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Marta Maria Zammuto
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Alessandro Mattina
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Internal Medicine, University of Palermo, Palermo, Italy.,IRCCS Centro Neurolesi "Bonibo-Pulejo", via Provinciale Palermo, Messina, Italy
| | - Luca Zanoli
- Clinical and Experimental Medicine, Section of Nephrology, University of Catania, Italy
| | - Calogero Geraci
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Antonio Granata
- Unit of Nephrology and Dialysis, San Giovanni di Dio" Hospital, Agrigento, Italy
| | - Emilio Nardi
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Internal Medicine, University of Palermo, Palermo, Italy.,IRCCS Centro Neurolesi "Bonibo-Pulejo", via Provinciale Palermo, Messina, Italy
| | | | - Santina Cottone
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Giuseppe Mulè
- Dipartimento Biomedico di Medicina Interna e Specialistica, Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
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Mwasongwe SE, Fülöp T, Katz R, Musani SK, Sims M, Correa A, Flessner MF, Young BA. Relation of uric acid level to rapid kidney function decline and development of kidney disease: The Jackson Heart Study. J Clin Hypertens (Greenwich) 2018; 20:775-783. [PMID: 29450959 PMCID: PMC6022371 DOI: 10.1111/jch.13239] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 01/08/2018] [Accepted: 01/12/2018] [Indexed: 01/13/2023]
Abstract
Whether elevated uric acid (UA) is an independent risk factor for chronic kidney disease (CKD) is not well established. The authors evaluated the relationship of UA with rapid kidney function decline (RKFD) and incident CKD among 3702 African Americans (AAs) in the Jackson Heart Study with serum UA levels measured at baseline exam (2000-2004). RKFD was defined as ≥ 30% eGFR loss and incident CKD as development of eGFR < 60 mL/min/1.73 m2 with a ≥ 25% decline in eGFR between baseline and exam 3 (2009-2013). RKFD and CKD were found in 11.4% and 7.5% of the participants, respectively. In a fully adjusted model, the odds of RKFD (OR, 1.8; 95% CI, 1.25-2.49) and incident CKD (OR, 2.00; 95% CI, 1.31-3.06) were significantly higher among participants in the top UA quartile vs bottom quartile. In the JHS, elevated UA was significantly associated with RKFD and incident CKD.
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Affiliation(s)
| | - Tibor Fülöp
- Department of MedicineDivision of NephrologyMedical University of South CarolinaCharlestonSCUSA
- Medical ServicesRalph H. Johnson VA Medical CenterCharlestonSCUSA
| | - Ronit Katz
- Division of NephrologyKidney Research InstituteUniversity of WashingtonSeattleWAUSA
| | - Solomon K. Musani
- Jackson Heart StudyUniversity of Mississippi Medical CenterJacksonMSUSA
| | - Mario Sims
- Jackson Heart StudyUniversity of Mississippi Medical CenterJacksonMSUSA
| | - Adolfo Correa
- Jackson Heart StudyUniversity of Mississippi Medical CenterJacksonMSUSA
| | | | - Bessie A. Young
- Division of NephrologyKidney Research InstituteUniversity of WashingtonSeattleWAUSA
- Veterans Affairs Puget Sound Health Care CenterSeattleWAUSA
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9
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Mulè G, Nardi E, Lattuca L, Cottone S. Hyperuricemia and high blood pressure at rest and during exercise: Guilty or innocent? The jury is still out. J Clin Hypertens (Greenwich) 2018; 20:557-559. [PMID: 29457338 DOI: 10.1111/jch.13227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Giuseppe Mulè
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Emilio Nardi
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Luigi Lattuca
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
| | - Santina Cottone
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Center, University of Palermo, Palermo, Italy
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10
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Jae SY, Bunsawat K, Choi YH, Kim YS, Touyz RM, Park JB, Franklin BA. Relation of serum uric acid to an exaggerated systolic blood pressure response to exercise testing in men with normotension. J Clin Hypertens (Greenwich) 2018; 20:551-556. [DOI: 10.1111/jch.13219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 11/01/2017] [Accepted: 11/07/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Sae Young Jae
- Department of Sport Science; University of Seoul; Seoul South Korea
| | - Kanokwan Bunsawat
- Department of Kinesiology and Nutrition; University of Illinois at Chicago; Chicago IL USA
| | - Yoon-Ho Choi
- Center for Health Promotion; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul South Korea
| | - Yeon Soo Kim
- Department of Physical Education; Seoul National University; Seoul South Korea
| | - Rhian M. Touyz
- Institute of Cardiovascular & Medical Sciences; University of Glasgow; Glasgow UK
| | - Jeong Bae Park
- Division of Cardiology; Cheil General Hospital; Dankook University College of Medicine; Seoul South Korea
| | - Barry A. Franklin
- Preventive Cardiology and Cardiac Rehabilitation; William Beaumont Hospital; Royal Oak MI USA
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11
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Hamadou B, Boombhi J, Kamdem F, Fitame A, Amougou SN, Mfeukeu LK, Nganou CN, Menanga A, Ashuntantang G. Prevalence and correlates of chronic kidney disease in a group of patients with hypertension in the Savanah zone of Cameroon: a cross-sectional study in Sub-Saharan Africa. Cardiovasc Diagn Ther 2017; 7:581-588. [PMID: 29302463 PMCID: PMC5752830 DOI: 10.21037/cdt.2017.08.09] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 08/07/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND The prevalence of chronic kidney disease (CKD) is increasing worldwide due to an increase in the risk factors such as hypertension. The greatest burden is in low-income settings, coupled with late diagnosis and limited management resources. This work aimed at studying the prevalence and risk factors of CKD in a group of patients with hypertension in the Savanah zone in Sub-Saharan Africa (SSA). METHODS We carried out a cross-sectional study between January and May 2016 in the regional Hospital of Garoua-Cameroon. Participants were adults ≥18 years of both sexes, who had a diagnosis of hypertension. Patients underwent a comprehensive clinical, biological, and electrocardiographic evaluation. RESULTS A total of 400 patients with hypertension were included, of whom 132 (33%; 95% CI: 28.6-37.8%) were males. Their mean age was 54.16±11.17 years. Hypertension was controlled in 122 (30.5%; 95% CI: 26.2-35.2%) participants. Twelve percent had a positive urine dipstick for proteins. The mean glomerular filtration rate (GFR) was 75.27±24.87 mL/min/1.73m2. The prevalence of CKD was seen in 129 (32.3%; 95% CI: 27.9-36.98) participants. Stage 3A was the most frequent (62.01%). The main comorbidities were anemia (44.5%), obesity (39.75%), diabetes (32%), consumption of traditional medicines (15.75%), and hyperuricemia (10.75%). After multivariate analysis, age >50 years (aOR: 1.75; 95% CI: 1.06-2.89; P=0.027), female sex (aOR: 2.21; 95% CI: 1.29-3.78; P=0.0035), obesity (aOR: 1.58, 95% CI: 1.01-2.44; P=0.026) and the hyperuricemia (aOR: 3.67; 95% CI: 1.78-7.58; P<0.001) were independently associated with CKD. CONCLUSIONS The prevalence of CKD in adults with hypertension was high. This was associated with age greater than 50 years, female sex, obesity and the hyperuricemia.
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Affiliation(s)
- Ba Hamadou
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Cardiology Unit, Central Hospital of Yaoundé, Yaoundé, Cameroon
| | - Jérôme Boombhi
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Cardiology Unit, Medicine B, General Hospital of Yaoundé, Yaoundé, Cameroon
| | - Félicité Kamdem
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Adeline Fitame
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Sylvie Ndongo Amougou
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Cardiology Unit, University Teaching Hospital of Yaoundé, Yaoundé, Cameroon
| | - Liliane Kuate Mfeukeu
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Cardiology Unit, Central Hospital of Yaoundé, Yaoundé, Cameroon
| | - Chris Nadège Nganou
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Cardiology Unit, Central Hospital of Yaoundé, Yaoundé, Cameroon
| | - Alain Menanga
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Cardiology Unit, Medicine B, General Hospital of Yaoundé, Yaoundé, Cameroon
| | - Gloria Ashuntantang
- Department of Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Nephrology and Hemodialysis Unit, General Hospital of Yaoundé, Yaoundé, Cameroon
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Sharaf El Din UA, Salem MM, Abdulazim DO. Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: A review. J Adv Res 2017; 8:537-548. [PMID: 28748119 PMCID: PMC5512153 DOI: 10.1016/j.jare.2016.11.004] [Citation(s) in RCA: 218] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 11/26/2016] [Accepted: 11/27/2016] [Indexed: 02/07/2023] Open
Abstract
The association between uric acid (UA) on one side and systemic hypertension (Htn), dyslipidemia, glucose intolerance, overweight, fatty liver, renal disease and cardiovascular disease (CVD) on the other side is well recognized. However, the causal relationship between UA and these different clinical problems is still debatable. The recent years have witnessed hundreds of experimental and clinical trials that favored the opinion that UA is a probable player in the pathogenesis of these disease entities. These studies disclosed the strong association between hyperuricemia and metabolic syndrome (MS), obesity, Htn, type 2 diabetes mellitus (DM), non-alcoholic fatty liver disease, hypertriglyceridemia, acute kidney injury, chronic kidney disease (CKD), coronary heart disease (CHD), heart failure and increased mortality among cardiac and CKD patients. The association between UA and nephrolithiasis or preeclampsia is a non-debatable association. Recent experimental trials have disclosed different changes in enzyme activities induced by UA. Nitric oxide (NO) synthase, adenosine monophosphate kinase (AMPK), adenosine monophosphate dehydrogenase (AMPD), and nicotinamide adenine dinucleotide phosphate (NADPH)-oxidase are affected by UA. These changes in enzymatic activities can lead to the observed biochemical and pathological changes associated with UA. The recent experimental, clinical, interventional, and epidemiologic trials favor the concept of a causative role of UA in the pathogenesis of MS, renal, and CVDs.
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Affiliation(s)
- Usama A.A. Sharaf El Din
- Nephrology Unit, Internal Medicine Department, School of Medicine, Cairo University, Egypt
- Corresponding author. Fax: +20 222753890.
| | - Mona M. Salem
- Endocrinology Unit, Internal Medicine Department, School of Medicine, Cairo University, Egypt
| | - Dina O. Abdulazim
- Rheumatology and Rehabilitation Department, School of Medicine, Cairo University, Egypt
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Regular physical activity prevents development of hypertension in young people with hyperuricemia. J Hypertens 2017; 35:994-1001. [DOI: 10.1097/hjh.0000000000001271] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Association between uric acid and renal function in hypertensive patients: which role for systemic vascular involvement? ACTA ACUST UNITED AC 2016; 10:559-569.e3. [PMID: 27247108 DOI: 10.1016/j.jash.2016.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 04/28/2016] [Accepted: 05/03/2016] [Indexed: 12/11/2022]
Abstract
The role of systemic vascular involvement in mediating the association between serum uric acid (SUA) and renal function in hypertension has not been explored. Main purpose of our study was to investigate whether morphofunctional vascular changes, assessed as carotid intima-media thickness (cIMT) and aortic pulse wave velocity (aPWV), might mediate the association between SUA and renal damage. We enrolled 523 hypertensive subjects with or without chronic kidney disease and divided population into tertiles of SUA based on sex-specific cutoff values. cIMT and aPWV were higher in uppermost SUA-tertile patients when compared to those in the lowest ones (all P < .001). Uricemia strongly correlated with cIMT and aPWV at univariate analysis (P < .001) and with cIMT after adjustment for confounders (P < .001). Adjustment for cIMT attenuated the relationship between SUA and estimated glomerular filtration rate (P = .019). Systemic vascular changes seem partially to mediate the association between SUA and renal function in hypertensive patients, regardless of kidney function.
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