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Alrouji M, Al-Kuraishy HM, Al-Gareeb AI, Alshammari MS, Alexiou A, Papadakis M, Bahaa MM, Batiha GES. Role of uric acid in neurodegenerative diseases, focusing on Alzheimer and Parkinson disease: A new perspective. Neuropsychopharmacol Rep 2024. [PMID: 39075837 DOI: 10.1002/npr2.12445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/19/2024] [Accepted: 04/07/2024] [Indexed: 07/31/2024] Open
Abstract
Neurodegenerative diseases (NDs) such as Alzheimer disease (AD) and Parkinson disease (PD) are group of diseases affecting the central nervous system (CNS) characterized by progressive neurodegenerations and cognitive impairment. Findings from different studies highlighted the beneficial and detrimental effects of serum uric acid on the development and progression of NDs. Therefore, this mini-review aims to discuss the beneficial and detrimental effects of uric on NDs. The neuroprotective effect of uric acid is mainly related to the antioxidant effect of uric acid which alleviates oxidative stress-induced neurodegeneration in AD and PD. However, long-term effect of hyperuricemia prompts for the development and progression of cognitive impairment. Hyperuricemia is associated with cognitive impairment and dementia, and gout increases dementia risk. In addition, hyperuricemia can cause cerebral vascular injury which is a risk factor for vascular dementia and cognitive impairment. Taken together, the relationship between uric acid and NDs risk remains conflicting. Hence, preclinical and clinical studies are indicated in this regard.
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Affiliation(s)
- Mohammed Alrouji
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Mohammed S Alshammari
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Athanasios Alexiou
- University Centre for Research & Development, Chandigarh University, Mohali, Punjab, India
- Department of Research & Development, Funogen, Athens, Greece
- Department of Research & Development, AFNP Med, Wien, Austria
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, New South Wales, Australia
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, University of Witten-Herdecke, Wuppertal, Germany
| | - Mostafa M Bahaa
- Faculty of Pharmacy, Pharmacy Practice Department, Horus University, New Damietta, Egypt
| | - Gaber El-Saber Batiha
- Faculty of Veterinary Medicine, Department of Pharmacology and Therapeutics, Damanhour University, Damanhour, Egypt
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Yang J, Xin C, Huo J, Li X, Dong H, Liu Q, Li R, Liu Y. Rab Geranylgeranyltransferase Subunit Beta as a Potential Indicator to Assess the Progression of Amyotrophic Lateral Sclerosis. Brain Sci 2023; 13:1531. [PMID: 38002490 PMCID: PMC10670085 DOI: 10.3390/brainsci13111531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/11/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Currently, there is no effective treatment for amyotrophic lateral sclerosis (ALS), a devastating neurodegenerative disorder. Many biomarkers have been proposed, but because ALS is a clinically heterogeneous disease with an unclear etiology, biomarker discovery for ALS has been challenging due to the lack of specificity of these biomarkers. In recent years, the role of autophagy in the development and treatment of ALS has become a research hotspot. In our previous studies, we found that the expression of RabGGTase (low RABGGTB expression and no change in RABGGTA) is lower in the lumbar and thoracic regions of spinal cord motoneurons in SOD1G93A mice compared with WT (wild-type) mice groups, and upregulation of RABGGTB promoted prenylation modification of Rab7, which promoted autophagy to protect neurons by degrading SOD1. Given that RabGGTase is associated with autophagy and autophagy is associated with inflammation, and based on the above findings, since peripheral blood mononuclear cells are readily available from patients with ALS, we proposed to investigate the expression of RabGGTase in peripheral inflammatory cells. METHODS Information and venous blood were collected from 86 patients diagnosed with ALS between January 2021 and August 2023. Flow cytometry was used to detect the expression of RABGGTB in monocytes from peripheral blood samples collected from patients with ALS and healthy controls. Extracted peripheral blood mononuclear cells (PBMCs) were differentiated in vitro into macrophages, and then the expression of RABGGTB was detected by immunofluorescence. RABGGTB levels in patients with ALS were analyzed to determine their impact on disease progression. RESULTS Using flow cytometry in monocytes and immunofluorescence in macrophages, we found that RABGGTB expression in the ALS group was significantly higher than in the control group. Age, sex, original location, disease course, C-reactive protein (CRP), and interleukin-6 (IL-6) did not correlate with the ALS functional rating scale-revised (ALSFRS-R), whereas the RABGGTB level was significantly correlated with the ALSFRS-R. In addition, multivariate analysis revealed a significant correlation between RABGGTB and ALSFRS-R score. Further analysis revealed a significant correlation between RABGGTB expression levels and disease progression levels (ΔFS). CONCLUSIONS The RABGGTB level was significantly increased in patients with ALS compared with healthy controls. An elevated RABGGTB level in patients with ALS is associated with the rate of progression in ALS, suggesting that elevated RABGGTB levels in patients with ALS may serve as an indicator for tracking ALS progression.
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Affiliation(s)
- Jing Yang
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China; (J.Y.); (C.X.); (J.H.); (X.L.); (H.D.); (Q.L.); (R.L.)
- The Key Laboratory of Neurology, Hebei Medical University, Ministry of Education, Shijiazhuang 050000, China
- Neurological Laboratory of Hebei Province, Shijiazhuang 050000, China
| | - Cheng Xin
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China; (J.Y.); (C.X.); (J.H.); (X.L.); (H.D.); (Q.L.); (R.L.)
- The Key Laboratory of Neurology, Hebei Medical University, Ministry of Education, Shijiazhuang 050000, China
- Neurological Laboratory of Hebei Province, Shijiazhuang 050000, China
| | - Jia Huo
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China; (J.Y.); (C.X.); (J.H.); (X.L.); (H.D.); (Q.L.); (R.L.)
- The Key Laboratory of Neurology, Hebei Medical University, Ministry of Education, Shijiazhuang 050000, China
- Neurological Laboratory of Hebei Province, Shijiazhuang 050000, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China; (J.Y.); (C.X.); (J.H.); (X.L.); (H.D.); (Q.L.); (R.L.)
- The Key Laboratory of Neurology, Hebei Medical University, Ministry of Education, Shijiazhuang 050000, China
- Neurological Laboratory of Hebei Province, Shijiazhuang 050000, China
| | - Hui Dong
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China; (J.Y.); (C.X.); (J.H.); (X.L.); (H.D.); (Q.L.); (R.L.)
- The Key Laboratory of Neurology, Hebei Medical University, Ministry of Education, Shijiazhuang 050000, China
- Neurological Laboratory of Hebei Province, Shijiazhuang 050000, China
| | - Qi Liu
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China; (J.Y.); (C.X.); (J.H.); (X.L.); (H.D.); (Q.L.); (R.L.)
- The Key Laboratory of Neurology, Hebei Medical University, Ministry of Education, Shijiazhuang 050000, China
- Neurological Laboratory of Hebei Province, Shijiazhuang 050000, China
| | - Rui Li
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China; (J.Y.); (C.X.); (J.H.); (X.L.); (H.D.); (Q.L.); (R.L.)
- The Key Laboratory of Neurology, Hebei Medical University, Ministry of Education, Shijiazhuang 050000, China
- Neurological Laboratory of Hebei Province, Shijiazhuang 050000, China
| | - Yaling Liu
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China; (J.Y.); (C.X.); (J.H.); (X.L.); (H.D.); (Q.L.); (R.L.)
- The Key Laboratory of Neurology, Hebei Medical University, Ministry of Education, Shijiazhuang 050000, China
- Neurological Laboratory of Hebei Province, Shijiazhuang 050000, China
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Kuwabara M, Fukuuchi T, Aoki Y, Mizuta E, Ouchi M, Kurajoh M, Maruhashi T, Tanaka A, Morikawa N, Nishimiya K, Akashi N, Tanaka Y, Otani N, Morita M, Miyata H, Takada T, Tsutani H, Ogino K, Ichida K, Hisatome I, Abe K. Exploring the Multifaceted Nexus of Uric Acid and Health: A Review of Recent Studies on Diverse Diseases. Biomolecules 2023; 13:1519. [PMID: 37892201 PMCID: PMC10604821 DOI: 10.3390/biom13101519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/21/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
The prevalence of patients with hyperuricemia or gout is increasing worldwide. Hyperuricemia and gout are primarily attributed to genetic factors, along with lifestyle factors like consuming a purine-rich diet, alcohol and/or fructose intake, and physical activity. While numerous studies have reported various comorbidities linked to hyperuricemia or gout, the range of these associations is extensive. This review article focuses on the relationship between uric acid and thirteen specific domains: transporters, genetic factors, diet, lifestyle, gout, diabetes mellitus, metabolic syndrome, atherosclerosis, hypertension, kidney diseases, cardiovascular diseases, neurological diseases, and malignancies. The present article provides a comprehensive review of recent developments in these areas, compiled by experts from the Young Committee of the Japanese Society of Gout and Uric and Nucleic Acids. The consolidated summary serves to enhance the global comprehension of uric acid-related matters.
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Affiliation(s)
- Masanari Kuwabara
- Department of Cardiology, Toranomon Hospital, 2-2-2-Toranomon, Minato, Tokyo 105-8470, Japan
| | - Tomoko Fukuuchi
- Laboratory of Biomedical and Analytical Sciences, Faculty of Pharma-Science, Teikyo University, Itabashi, Tokyo 173-8605, Japan;
| | - Yuhei Aoki
- Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Takamatsu 761-0793, Kagawa, Japan;
| | - Einosuke Mizuta
- Department of Cardiology, Sanin Rosai Hospital, Yonago 683-8605, Tottori, Japan;
| | - Motoshi Ouchi
- Department of Health Promotion in Nursing and Midwifery, Innovative Nursing for Life Course, Graduate School of Nursing, Chiba University, Chiba 260-8672, Chiba, Japan;
- Department of Pharmacology and Toxicology, School of Medicine, Dokkyo Medical University, Mibu 321-0293, Tochigi, Japan
| | - Masafumi Kurajoh
- Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka 5454-8585, Osaka, Japan;
| | - Tatsuya Maruhashi
- Department of Regenerative Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Hiroshima, Japan;
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga 849-8501, Saga, Japan;
| | - Nagisa Morikawa
- Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume 830-0011, Fukuoka, Japan;
- Department of Community Medicine, Kurume University School of Medicine, Kurume 830-0011, Fukuoka, Japan
| | - Kensuke Nishimiya
- Department of Cardiovascular Medicine, Tohoku University Hospital, Sendai 980-8574, Miyagi, Japan;
| | - Naoyuki Akashi
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Saitama, Japan;
| | - Yoshihiro Tanaka
- Division of Epidemiology, Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka 420-0881, Shizuoka, Japan;
| | - Naoyuki Otani
- Cardiovascular Center, Dokkyo Medical University Nikko Medical Center, Nikko 321-1298, Tochigi, Japan;
| | - Mihoko Morita
- Department of Hematology and Oncology, University of Fukui Hospital, Eiheiji 910-1193, Fukui, Japan;
| | - Hiroshi Miyata
- Department of Pharmacy, The University of Tokyo Hospital, Bunkyo, Tokyo 113-8655, Japan; (H.M.); (T.T.)
| | - Tappei Takada
- Department of Pharmacy, The University of Tokyo Hospital, Bunkyo, Tokyo 113-8655, Japan; (H.M.); (T.T.)
| | - Hiroshi Tsutani
- National Hospital Organization Awara Hospital, Awara 910-4272, Fukui, Japan;
| | - Kazuhide Ogino
- Department of Cardiology, Japanese Red Cross Tottori Hospital, Tottori 680-8517, Tottori, Japan;
| | - Kimiyoshi Ichida
- Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo 192-0392, Japan;
| | - Ichiro Hisatome
- National Hospital Organization Yonago Medical Center, Yonago 683-0006, Tottori, Japan;
| | - Kohtaro Abe
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Fukuoka, Japan;
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Hussein S, Pingili S, Makkena VK, Jaramillo AP, Awosusi BL, Ayyub J, Dabhi KN, Gohil NV, Tanveer N, Hamid P. The Impact of Serum Uric Acid on the Progression of Amyotrophic Lateral Sclerosis in Adults Aged 18 and Older: A Systematic Review. Cureus 2023; 15:e42312. [PMID: 37614251 PMCID: PMC10444204 DOI: 10.7759/cureus.42312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 07/22/2023] [Indexed: 08/25/2023] Open
Abstract
We have conducted this review to see if serum uric acid (UA) is associated with slowing amyotrophic lateral sclerosis (ALS) progression in adult patients who are at least 18 years old. Understanding the effects of this biomarker for future use is critical because of its easy accessibility. This systematic review paper examined five previous years of recent studies and reports, published in English and limited to human investigations from the Cochrane, PubMed, and Google Scholar databases. Using instruments for assessing the eligibility and quality of systematic and narrative reviews, we narrowed our search to 11 reports that show evidence of a positive association between high blood uric acid and the progression of ALS. However, this claim still needs confirmation by future studies to confirm that possibility. The results of this systematic review may provide a strong foundation for future studies on this biomarker, demonstrating the significance of blood uric acid levels in ALS and highlighting the necessity of using that biomarker to track the disease's progression.
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Affiliation(s)
- Sally Hussein
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Shravya Pingili
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
- Medicine/Surgery, Kakatiya Medical College, Hyderabad, IND
| | - Vijaya Krishna Makkena
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
- Medicine/Surgery, Osmania Medical College, Hyderabad, IND
| | - Arturo P Jaramillo
- General Practice, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Babatope L Awosusi
- Pathology and Laboratory Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Javaria Ayyub
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Karan Nareshbhai Dabhi
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Namra V Gohil
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
- Internal Medicine, Medical College Baroda, Vadodara, IND
| | - Nida Tanveer
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
- Internal Medicine, University of Louisville, Louisville, USA
| | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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Otani N, Hoshiyama E, Ouchi M, Takekawa H, Suzuki K. Uric acid and neurological disease: a narrative review. Front Neurol 2023; 14:1164756. [PMID: 37333005 PMCID: PMC10268604 DOI: 10.3389/fneur.2023.1164756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/05/2023] [Indexed: 06/20/2023] Open
Abstract
Hyperuricemia often accompanies hypertension, diabetes, dyslipidemia, metabolic syndrome, and chronic renal disease; it is also closely related to cardiovascular disease. Moreover, several epidemiological studies have linked hyperuricemia and ischemic stroke. However, uric acid may also have neuroprotective effects because of its antioxidant properties. An association between low uric acid levels and neurodegenerative diseases has been suggested, which may be attributed to diminished neuroprotective effects as a result of reduced uric acid. This review will focus on the relationship between uric acid and various neurological diseases including stroke, neuroimmune diseases, and neurodegenerative diseases. When considering both the risk and pathogenesis of neurological diseases, it is important to consider the conflicting dual nature of uric acid as both a vascular risk factor and a neuroprotective factor. This dual nature of uric acid is important because it may help to elucidate the biological role of uric acid in various neurological diseases and provide new insights into the etiology and treatment of these diseases.
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Affiliation(s)
- Naoyuki Otani
- Department of Cardiology, Dokkyo Medical University Nikkyo Medical Center, Mibu, Japan
| | - Eisei Hoshiyama
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Motoshi Ouchi
- Department of Pharmacology and Toxicology, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Hidehiro Takekawa
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
- Stroke Center, Dokkyo Medical University, Mibu, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
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Kutlubaev MA, Areprintseva DK, Pervushina EV. [The influence of uric acid on the course of amyotrophic lateral sclerosis]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:177-180. [PMID: 37315259 DOI: 10.17116/jnevro2023123051177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Uric acid has antioxidant and neuroprotective properties. A number of studies show that high levels of uric acid may have a positive influence on the course of amyotrophic lateral sclerosis (ALS), especially in males. The frequency of ALS is lower in patients with gout than in the general population. We present a case of a patient with gout and slowly progressive ALS. More research is needed on the potential role of uric acid in ALS and other neurodegenerative disorders.
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He X, Feng J, Cong X, Huang H, Zhao Q, Shen Q, Xu F, Xu Y. A Prediction Model for Peak Expiratory Flow Derived From Venous Blood Biomarkers and Clinical Factors in Amyotrophic Lateral Sclerosis. Front Public Health 2022; 10:899027. [PMID: 35692305 PMCID: PMC9184518 DOI: 10.3389/fpubh.2022.899027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/29/2022] [Indexed: 12/03/2022] Open
Abstract
Although peripheral venous blood biomarkers are related to respiratory function in Amyotrophic lateral sclerosis (ALS) patients, there are still few prediction models that predict pulmonary function. This study aimed to investigate the venous blood biomarkers associated with respiratory function in patients with ALS from southwest China and to create prediction models based on those clinical biomarkers using logistic regression. A total of 319 patients with ALS from the retrospective cohort and 97 patients with ALS from the prospective cohort were enrolled in this study. A multivariable prediction model for the correlation between peak expiratory flow (PEF) and hematologic, biochemical laboratory parameters, and clinical factors in patients with ALS was created. Along with female patients, bulbar-onset, lower body mass index (BMI), later age of onset, lower level of creatinine, uric acid, triglyceride, and a higher level of high-density lipoprotein cholesterol (HDL_C) were related to reduced PEF. The area under the receiver operating characteristics (ROC) curve is.802 for the test set and.775 for the validation set. The study constructed a multivariable prediction model for PEF in patients with ALS. The results can be helpful for clinical practice to predict respiratory impairment.
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Affiliation(s)
- Xianghua He
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- Department of Neurology, Jiangbin Hospital, Nanning, China
| | - Jiaming Feng
- West China Clinical Medical College, Sichuan University, Chengdu, China
| | - Xue Cong
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Hongyan Huang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Quanzhen Zhao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiuyan Shen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Fang Xu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yanming Xu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Yanming Xu
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Abstract
PURPOSE OF REVIEW In this review, we report on new findings regarding associations of uric acid with kidney health. We discuss kidney stones, effects of uric acid in chronic kidney disease (CKD), and management of gout in CKD. Recent studies on neuroprotective effects of raising uric acid provide interesting data regarding nephrolithiasis. RECENT FINDINGS Elevated urate levels have been implicated in the progression of chronic kidney disease (CKD), but the results from PERL and CKD-FIX studies did not demonstrate that allopurinol slowed CKD progression. The SURE-PD3 sought to determine if increasing uric acid would slow the progression of Parkinson's disease. Results ultimately did not support this hypothesis, but high urinary uric acid levels caused uric acid stones, not calcium stones. Low urinary pH remains the key to the formation of uric acid stones. Thiazolidinediones improve insulin resistance, which is associated with an increase in urine pH. The most recent research has not supported the hypothesis that lowering serum uric acid levels will slow the progression of CKD or provide neuroprotection in Parkinson's disease. It is still unclear as to why uric acid stone formers have a high net acid excretion. The STOP-GOUT trial demonstrates that there was a lack of significant adverse events with higher urate-lowering dosages of allopurinol and febuxostat, despite patients' kidney function. This may push other studies to administer higher dosages per ACR guidelines. Future studies could then demonstrate decreased progression of CKD.
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Affiliation(s)
- Giana Kristy Ramos
- Nephrology Division, NYU Langone Health, New York, NY, USA
- New York Harbor VA Healthcare System, New York, NY, USA
| | - David S Goldfarb
- Nephrology Division, NYU Langone Health, New York, NY, USA.
- New York Harbor VA Healthcare System, New York, NY, USA.
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