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    Predictive effect of hyperuricemia on left atrial stasis in non-valvular atrial fibrillation patients.
    Int J Cardiol 2018 Feb 2. Epub 2018 Feb 2.
    Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, China. Electronic address:
    Objectives: To investigate the relationship between hyperuricemia and left atrial thrombus (LAT)/spontaneous echo contrast (SEC) and to determine the predictive value of hyperuricemia in non-valvular (NV) atrial fibrillation (AF) patients.

    Methods: The study retrospectively reviewed 1198 consecutive patients (male 801, female 397, and mean age of 56.84 ± 12. Read More

    Relationship between serum urate concentration and clinically evident incident gout: an individual participant data analysis.
    Ann Rheum Dis 2018 Feb 20. Epub 2018 Feb 20.
    Department of Biochemistry, University of Otago, Dunedin, New Zealand.
    Objectives: To provide estimates of the cumulative incidence of gout according to baseline serum urate.

    Methods: Using individual participant data from four publicly available cohorts (Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, and both the Original and Offspring cohorts of the Framingham Heart Study), the cumulative incidence of clinically evident gout was calculated according to baseline serum urate category. Cox proportional hazards modelling was used to evaluate the relation of baseline urate categories to risk of incident gout. Read More

    Risk Factor for Diabetes Mellitus and High Blood Glucose With HMG-CoA Reductase Inhibitors Using a Postmarketing Surveillance Database in Japan.
    Clin Pharmacol Drug Dev 2018 Feb 20. Epub 2018 Feb 20.
    Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
    To investigate whether 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor (statin) use is associated with an increased risk of diabetes mellitus and hyperglycemia, we performed a nested case-control study using a postmarketing surveillance database in Japan. The database cohort included 26,849 cases of statin use and 5308 cases of other lipid-lowering drug use in patients with hyperlipidemia. Participants received at least 1 type of statin, had a clear medication history of statin use, and had no complications of diabetes mellitus. Read More

    Levels of cytokines and microRNAs in individuals with asymptomatic hyperuricemia and ultrasonographic findings of gout: a bench-to-bedside approach.
    Arthritis Care Res (Hoboken) 2018 Feb 18. Epub 2018 Feb 18.
    Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
    Objective: To assess potential associations among serum cytokines and microRNA (miR) levels with ultrasound (US) findings suggestive of urate deposits in chronic asymptomatic hyperuricemia and gout.

    Methods: All participants underwent musculoskeletal US and measurements of serum IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-13, IFN-γ, TNF, MCP-1, and ENA-78, as well as miR-146a, miR-155, and miR-223 levels.

    Results: Thirty individuals with asymptomatic hyperuricemia, 31 normouricemic controls, and 30 gouty patients were included. Read More

    Effects of complete water fasting and regeneration diet on kidney function, oxidative stress and antioxidants.
    Bratisl Lek Listy 2018 ;119(2):107-111
    Objective: The aim of the study was to observe the influence of 11-days complete water fasting (WF) and regeneration diet (RD) on renal function, body weight, blood pressure and oxidative stress.

    Background: Therapeutic WF is considered a healing method.

    Methods: Ten volunteers drank only water for 11 days, followed by RD for the next 11 days. Read More

    [Progress on diagnosis and treatment of tophus].
    Zhongguo Gu Shang 2017 Sep;30(9):876-880
    Department of Pain, the First Affiliated Hospital of Gannan Medical Unversity, Ganzhou 341000, Jiangxi, China.
    Tophi deposit in the peripheral bone joints or soft tissues are formed by uric acid and urate crystal. It does not only affect local appearance but also destroy the bone and joint structure, resulting in loss of function. Traditional medical treatment is an effective way to control the hyperuricemia, but it is ineffective to tophus. Read More

    ABCG2 contributes to the development of gout and hyperuricemia in a genome-wide association study.
    Sci Rep 2018 Feb 16;8(1):3137. Epub 2018 Feb 16.
    Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
    Although many genome-wide association studies (GWASs) of hyperuricemia or gout have been reported, the related genetic factors and the mechanisms from hyperuricemia to gouty attack remain unclear. This study aimed to identify genetic factors and pathogenesis of gout from hyperuricemia by genome-wide association study (GWAS). 747 gout patients, 747 hyperuricemia and 2071 age-matched controls were recruited and analyzed with Affymetrix 650 K chip to find the related genetic variants. Read More

    Impaired arterial responsiveness in untreated gout patients compared with healthy non-gout controls: association with serum urate and C-reactive protein.
    Clin Rheumatol 2018 Feb 15. Epub 2018 Feb 15.
    Section of Rheumatology, VA New York Harbor Health Care System, NY Campus, New York, NY, USA.
    To determine whether arterial responsiveness is impaired among patients with gout, and whether arterial responsiveness inversely correlates with serum urate and inflammatory measures. This is a cross-sectional study of untreated gout subjects (n = 34) and non-gout healthy controls (n = 64). High-resolution dynamic ultrasound-measured flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD) assessed endothelium-dependent and endothelium-independent arterial responsiveness respectively. Read More

    Serum uric acid is associated with incidence of heart failure with preserved ejection fraction and cardiovascular events in patients with arterial hypertension.
    J Clin Hypertens (Greenwich) 2018 Feb 15. Epub 2018 Feb 15.
    Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
    The objective of the present study was to evaluate clinical implications of serum uric acid (UA) on the progression of heart failure with preserved ejection fraction (HFpEF) in hypertensive patients. A total of 1009 adult patients with left ventricular hypertrophy and suspected left ventricular diastolic dysfunction were enrolled at our hospital from January 2008 to December 2011. With a median follow-up of 7. Read More

    Hypouricaemic effects of yogurt containing Lactobacillus gasseri PA-3 in patients with hyperuricaemia and/or gout: a randomized, double-blind, placebo-controlled study.
    Mod Rheumatol 2018 Feb 15:1-17. Epub 2018 Feb 15.
    b Food Science Research Laboratories, Meiji Co., Ltd. , Kanagawa , Japan.
    Purpose: Lactobacillus gasseri PA-3 (PA-3) has been previously shown to decrease serum uric acid (SUA) levels in subjects with increased SUA. In this study, we investigated whether PA-3 is also capable of decreasing SUA levels in patients with hyperuricaemia and/or gout.

    Methods: Twenty-five patients with hyperuricaemia and/or gout completed this study. Read More

    High Uric Acid Inhibits Cardiomyocyte Viability Through the ERK/P38 Pathway via Oxidative Stress.
    Cell Physiol Biochem 2018 8;45(3):1156-1164. Epub 2018 Feb 8.
    Department of Internal Medicine, The Second Affiliated Hospital of Shantou, University Medical College, Shantou, China.
    Background/aims: Clinical studies have shown that hyperuricaemia is strongly associated with cardiovascular disease. However, the molecular mechanisms of high uric acid (HUA) associated with cardiovascular disease remain poorly understood. In this study, we investigated the effect of HUA on cardiomyocytes. Read More

    Interaction Between the Sodium-Glucose-Linked Transporter 2 Inhibitor Dapagliflozin and the Loop Diuretic Bumetanide in Normal Human Subjects.
    J Am Heart Assoc 2018 Feb 10;7(4). Epub 2018 Feb 10.
    Bristol-Myers Squibb, Princeton, NJ.
    Background: Dapagliflozin inhibits the sodium-glucose-linked transporter 2 in the renal proximal tubule, thereby promoting glycosuria to reduce hyperglycemia in type 2 diabetes mellitus. Because these patients may require loop diuretics, and sodium-glucose-linked transporter 2 inhibition causes an osmotic diuresis, we evaluated the diuretic interaction between dapagliflozin and bumetanide.

    Methods And Results: Healthy subjects (n=42) receiving a fixed diet with ≈110 mmol·dof Nawere randomized to bumetanide (1 mg·d), dapagliflozin (10 mg·d), or both for 7 days, followed by 7 days of both. Read More

    Serum uric acid levels and outcome during admission in acute ischaemic stroke, depending on renal function.
    Int J Neurosci 2018 Feb 13:1-26. Epub 2018 Feb 13.
    b Nephrology Department , University Hospital "Infanta Cristina", Badajoz, Avda de Elvas s/n. 06080 Badajoz , Spain.
    Background: The relationship between serum uric acid (SUA) levels and stroke is controversial. The discrepancies in the results could be due to the uneven setting of comorbidity. It is known that hyperuricaemia increases in parallel with the decline in renal function; however, there are few studies that adjust for renal disease. Read More

    Uric acid, metabolic syndrome and atherosclerosis: the chicken or the egg, which comes first?
    Endocr Metab Immune Disord Drug Targets 2018 Feb 11. Epub 2018 Feb 11.
    Cardiovascular Disease Section, Department of Organ Trasplantation, University of Bari. Italy.
    Background: A great debate in literature exists nowadays on the role of uric acid as a marker of cardiovascular and metabolic organ damage or a risk factor for cardiovascular and metabolic disease.

    Methods: to determine the relationship among serum uric acid and metabolic syndrome and atherosclerosis, by mean of carotid intima media-thickness, in a cohort of 811 otherwise healthy overweight/obese subjects, without overt atherosclerosis not using any kind of drug.

    Results: Uric acid levels were positively related to male gender, waist circumference, BMI, systolic and diastolic pressure levels, fasting insulin, fasting glucose, HOMA-IR, triglycerides, total cholesterol, LDL cholesterol, the presence of metabolic syndrome and the number of the components of metabolic syndrome and negative related to HDL cholesterol levels. Read More

    Managing Gout in the Patient with Renal Impairment.
    Drugs Aging 2018 Feb 13. Epub 2018 Feb 13.
    Hospital General Universitario de Alicante, calle del Roble 6, 03015, Alicante, Spain.
    Hyperuricaemia is an independent risk factor for renal function decline. Evidence is emerging that urate-lowering therapy might be beneficial in subjects with renal impairment. We  review the association between renal impairment and gout, some of the related pathogenic processes and the possible impact of gout treatment on the progression of renal impairment. Read More

    Uric acid is associated with long-term adverse cardiovascular outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention.
    Atherosclerosis 2018 Feb 9;270:173-179. Epub 2018 Feb 9.
    3rd Medical Department with Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna, Austria; Sigmund Freud University, Medical Faculty, Vienna, Austria.
    Background And Aims: Evidence links uric acid (UA) with the promotion of cardiovascular disease. We assessed the prognostic value of UA on long-term major adverse outcomes (MACE) in patients with acute coronary syndrome (ACS), undergoing percutaneous coronary intervention (PCI).

    Methods: As primary endpoint, we assessed the association of UA (continuous and dichotomized) with MACE, including cardiovascular death, myocardial infarction (MI) and stroke, using Cox regression and propensity matching. Read More

    Markers of Iron Status Are Associated with Risk of Hyperuricemia among Chinese Adults: Nationwide Population-Based Study.
    Nutrients 2018 Feb 9;10(2). Epub 2018 Feb 9.
    Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing 100191, China.
    Background: Elevated serum uric acid (SUA) involved in iron metabolism, has been increasingly recognized as a risk factor for gout and cardiovascular diseases. The objective of this study was to examine the associations between markers of iron status with risk of hyperuricemia (HU) in Chinese adult population.

    Methods: Data were extracted from the 2009 wave of the China Health and Nutrition Survey, consisting of 7946 apparently healthy adults. Read More

    Correlations between blood uric acid and the incidence and progression of type 2 diabetes nephropathy.
    Eur Rev Med Pharmacol Sci 2018 Jan;22(2):506-511
    Department of Endocrinology, The First People's Hospital of Wujiang District Suzhou, Suzhou, China.
    Objective: To investigate the relationships between blood uric acid (BUA) level and the incidence, progression and deterioration of diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM).

    Patients And Methods: A total of fifty patients with T2DM alone whose glycosylated hemoglobin (HbA1c) were under normal range (4-6.5%) at their admission to our hospital were randomly selected as diabetes mellitus (DM) group. Read More

    A novel UMOD gene mutation associated with chronic kidney failure at a young age.
    Clin Nephrol 2018 Feb 9. Epub 2018 Feb 9.
    Autosomal dominant tubulointerstitial kidney disease (ADTKD) belongs to a group of renal hereditary disorders linked by common findings of tubulointerstitial disease and dominant inheritance. The renal clinical phenotype is characterized by chronic kidney disease, hyperuricemia, gout, and, inconstantly, renal cysts. Uromodulin (UMOD) gene mutations are related to the clinical phenotype of ADTKD-UMOD. Read More

    Cordycepin, a Characteristic Bioactive Constituent in, Ameliorates Hyperuricemia through URAT1 in Hyperuricemic Mice.
    Front Microbiol 2018 25;9:58. Epub 2018 Jan 25.
    Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.
    Recently, we've reported the anti-hyperuricemic effects of. As a characteristic compound of, we hypothesized that cordycepin may play a role in preventing hyperurecimia. Remarkably, cordycepin produced important anti-hyperuricemic actions, decreasing SUA (serum uric acid) to 216, 210, and 203 μmol/L (< 0. Read More

    Assessment of the association between serum uric acid levels and the incidence of hypertension in nonmetabolic syndrome subjects: A prospective observational study.
    Medicine (Baltimore) 2018 Feb;97(6):e9765
    Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
    The purpose of this study was to examine the association between serum uric acid (sUA) and the incidence of hypertension in nonmetabolic syndrome (non-MetS) subjects.This was a prospective observational study including 23,525 subjects who had been followed up for at least 5 years. A logistic regression model was used to assess independent risk factors associated with hypertension. Read More

    Soluble uric acid increases PDZK1 and ABCG2 expression in human intestinal cell lines via the TLR4-NLRP3 inflammasome and PI3K/Akt signaling pathway.
    Arthritis Res Ther 2018 Feb 7;20(1):20. Epub 2018 Feb 7.
    Department of Rheumatology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 310009, Hangzhou, China.
    Background: In addition to the kidney, the intestine is one of the most important organs involved in uric acid excretion. However, the mechanism of urate excretion in the intestine remains unclear. Therefore, the relationship between soluble uric acid and the gut excretion in human intestinal cells was explored. Read More

    Gender-related differences in clinicopathological characteristics and renal outcomes of Chinese patients with IgA nephropathy.
    BMC Nephrol 2018 02 7;19(1):31. Epub 2018 Feb 7.
    Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, Guangdong, 510080, China.
    Background: The prognostic effect of gender on immunoglobulin A nephropathy (IgAN) is not clear. We explored gender-related differences in clinicopathological features and renal outcomes in IgAN.

    Methods: This was a single-centre retrospective study. Read More

    Associations of hyperuricemia and obesity with remission of nonalcoholic fatty liver disease among Chinese men: A retrospective cohort study.
    PLoS One 2018 7;13(2):e0192396. Epub 2018 Feb 7.
    Department of Educational affairs, Southwest Medical University, Luzhou, China.
    Nonalcoholic fatty liver disease (NAFLD) is a common chronic disease that is associated with high serum uric acid (SUA) levels, although the effects of high SUA levels on NAFLD remission remain unclear. In addition, it is unclear whether obesity and high SUA levels have a combined effect on NAFLD remission. This retrospective cohort study evaluated male employees of seven Chinese companies and investigated the association between high SUA levels and NAFLD remission, as well as the potential combined effect of high SUA levels and obesity on NAFLD remission. Read More

    The revised GOLD 2017 COPD categorization in relation to comorbidities.
    Respir Med 2018 Jan 5;134:79-85. Epub 2017 Dec 5.
    Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M), Ludwig-Maximilians-Universität München, Ziemssenstr. 1, 80336 Munich, Germany.
    Introduction: The COPD classification proposed by the Global Initiative for Obstructive Lung Disease was recently revised, and the A to D grouping is now based on symptoms and exacerbations only. Potential associations with comorbidities have not been assessed so far. Thus the aim of the present study was to determine the relationship between the revised (2017) GOLD groups A-D and major comorbidities. Read More

    Hyperuricemia is associated with short-term outcomes in elderly patients with acute myocardial infarction.
    Aging Clin Exp Res 2018 Feb 6. Epub 2018 Feb 6.
    Tangshan Gongren Hospital, Tangshan, Hebei, China.
    Background: Although a lot of studies have  shown serum uric acid (SUA) could be a marker of adverse prognosis in patients with acute myocardial infarction, the role of SUA as a risk factor for myocardial infarction is controversial. This study aimed to evaluate the association between hyperuricemia and short-term outcomes of elderly patients with acute ST-segment elevation myocardial infarction (STEMI).

    Methods: Six hundred and seventy-three elderly patients (≥ 60 years) were divided into high-SUA-level group (group H: N = 168) and low-SUA-level group (group L: N = 505) according to the SUA levels on admission. Read More

    Association of hyperglycemic crisis with an increased risk of end-stage renal disease: a nationwide population-based cohort study.
    Diabetes Res Clin Pract 2018 Feb 1. Epub 2018 Feb 1.
    Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Bachelor Program of Senior Service, Southern Taiwan University of Science and Technology, Tainan, Taiwan; Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan; Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan. Electronic address:
    Background: A hyperglycemic crisis episode (HCE) is associated with poor management of diabetes, which is a risk factor for end-stage renal disease (ESRD); however, the association between an HCE and ESRD has not been clarified. We conducted a nationwide population-based cohort study with the purpose of delineating this issue.

    Methods: We identified 9,208 diabetic patients with an HCE and an identical number of diabetic patients with matched age, sex, and index date without an HCE between 2000 and 2002. Read More

    The polymorphism rs671 at ALDH2 associated with serum uric acid levels in Chinese Han males: A genome-wide association study.
    Gene 2018 Feb 2. Epub 2018 Feb 2.
    Department of Pathology, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, PR China; Key Laboratory of Disease Proteomics of Zhejiang Province, Hangzhou, Zhejiang 310058, PR China. Electronic address:
    Serum uric acid (SUA) levels are highly heritable and an increased SUA level is one of important risk factors for gout, diabetes, metabolic syndrome, and cardiovascular diseases. The genetic variants underlying SUA remains largely unexplored. The aim was to explore new genetic variants underlying SUA in Chinese Han. Read More

    Design, synthesis and biological evaluation of 1-hydroxy-2-phenyl-4-pyridyl-1H-imidazole derivatives as xanthine oxidase inhibitors.
    Eur J Med Chem 2018 Feb 31;146:668-677. Epub 2018 Jan 31.
    Key Laboratory of Structure-Based Drugs Design & Discovery of Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, 103 Culture Road, Shenhe District, Shenyang 110016, China. Electronic address:
    In our previous study, we reported a series of 1-hydroxy-2-phenyl-1H-imidazole-5-carboxylic acid derivatives that presented excellent in vitro xanthine oxidase inhibitory potency. As a continuation study, a series of 1-hydroxy-2-phenyl-1H-imidazole derivatives containing a pyridine moiety (4a-g and 5a-g) at the 4-position was designed and synthesized. Evaluation of in vitro xanthine oxidase inhibition demonstrated that the 4a-g series was more potent than the 5a-g series. Read More

    Hyperuricemia as a prognostic factor after acute coronary syndrome.
    Atherosclerosis 2018 Feb 17;269:229-235. Epub 2018 Jan 17.
    Cardiology Department, Hospital of San Juan de Alicante, San Juan De Alicante, Spain.
    Background And Aims: Many studies have reported the independent association between uric acid and cardiovascular disease, its role as a risk predictor for outcomes in people with acute coronary syndrome remains controversial. This study aims to assess the association between hyperuricemia and medium/long-term clinical outcomes in people with acute coronary syndrome and determine whether adding hyperuricemia to the GRACE score improves its predictive capability.

    Methods: This cohort study included patients admitted for acute coronary syndrome between 2008 and 2013. Read More

    Disturbed purine nucleotide metabolism in chronic kidney disease is a risk factor for cognitive impairment.
    Med Hypotheses 2018 Feb 13;111:36-39. Epub 2017 Dec 13.
    Cellular & Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, P.O. Dorgakona, Cachar, Silchar 788011, Assam, India. Electronic address:
    Chronic kidney disease (CKD) is an increasing global health burden. Disturbance in purine metabolism pathway and a higher level of serum uric acid, called hyperuricemia, is a risk factor of CKD, and it has been linked to increased prevalence and progression of the disease. In a recent study, it has been demonstrated that purine nucleotides and uric acid alter the activity of acetylcholinesterase (AChE). Read More

    Dysregulation of Tryptophan Catabolism in Metabolic Syndrome.
    Metab Syndr Relat Disord 2018 Feb 6. Epub 2018 Feb 6.
    2 Instituto Leônidas e Maria Deane (ILMD) , Fiocruz Amazônia, Manaus, Amazonas, Brazil .
    Objective: Obesity and metabolic syndrome are preventable complex-multifactorial disorders that severely increase risk of cardiovascular disease (CVD). Indoleamine 2,3-dioxygenase (IDO) enzyme converts tryptophan (TRP) to kynurenine (KYN); besides, KYN/TRP ratio has been shown to predict major coronary events and all-cause mortality in patients with coronary artery disease. However, their role in metabolic syndrome is not understood. Read More

    An association of smoking with serum urate and gout: A health paradox.
    Semin Arthritis Rheum 2017 Nov 22. Epub 2017 Nov 22.
    Department of Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand.
    Background: The potential effect of cigarette smoking on levels of serum urate and risk of gout has been considered by a large number of studies, either as the primary variable of interest or as a covariate.

    Methods: Here we systematically review the published evidence relating to the relationship of smoking with serum urate, hyperuricaemia, and gout.

    Results: Many studies have reported that smoking reduces serum urate, however, the evidence has not been conclusive with other studies pointing to the opposite or no effect. Read More

    Uric Acid as a Cause of the Metabolic Syndrome.
    Contrib Nephrol 2018 23;192:88-102. Epub 2018 Jan 23.
    Hyperuricemia is common in subjects with obesity, metabolic syndrome, and type 2 diabetes. For many years, hyperuricemia was attributed to the effects of insulin resistance to reduce urinary excretion of uric acid, and it was believed that uric acid may not have any causal role in the metabolic syndrome. However, in recent years, hyperuricemia has been found to independently predict the development of diabetes. Read More

    Systemic Implications of Hyperuricemia.
    Contrib Nephrol 2018 23;192:82-87. Epub 2018 Jan 23.
    Senior professor - Head of the Renal Health Area in the Academic Secretariat from the National Institute of Public Health, S.S.A. Member of the National Academy of Medicine, Mexico City, Mexico.
    Systemic implications of hyperuricemia need to be reconsidered in the context of the energy and protein wasting being an early indicator of organ deterioration in patients affected by the cardiometabolic syndrome and other frequent pathology states like pre-eclampsia, hyperparathyroidism, and chronic renal failure. This chapter points out physiological alterations that are to be made related to hyperuricemia, new diagnostic strategies, and early therapeutic interventions in the context of the old enemy: asymptomatic hyperuricemia. This chapter also concludes with a proposal to undertake research in this emerging, primary care, cost-efficient scenario. Read More

    Uric Acid in Pregnancy: New Concepts.
    Contrib Nephrol 2018 23;192:110-115. Epub 2018 Jan 23.
    The relationship between hyperuricemia and hypertensive disorders is well established; however, until today, the role of uric acid in the clinical course of severe preeclampsia has not been elucidated. Some recent studies suggest that at the time of presentation, subjects with severe preeclampsia frequently have significantly elevated serum uric acid levels, and that the degree of elevation correlates with the severity of the maternal syndrome and fetal morbimortality. In this chapter, we present our workgroup experience. Read More

    Significance of Hyperuricemia among Community-Based Screening Participants.
    Contrib Nephrol 2018 23;192:41-47. Epub 2018 Jan 23.
    Clinical Research Support Center, Tomishiro Central Hospital, Okinawa, Japan.
    Background: Chronic kidney disease (CKD) is a risk factor of cardiovascular disease (CVD) and end-stage renal disease (ESRD). Early detection and management of risk factors of incidence and progression of CKD are necessary. We have been studying these risk factors among community-based screening participants in Okinawa, Japan. Read More

    Treatment of Hyperuricemia in Chronic Kidney Disease.
    Contrib Nephrol 2018 23;192:135-146. Epub 2018 Jan 23.
    Hyperuricemia may be a major contributor to the development or progression of chronic kidney disease (CKD). Although there is no clear cutoff uric acid (UA) value associated to the risk for kidney damage, it appears to be an increased risk as UA rises. Lifestyle interventions such as exercise, weight reduction, low consumption of purine-rich meat, or avoiding high fructose intake are recommended for all hyperuricemic patients. Read More

    Hyperuricemia and Progression of Chronic Kidney Disease: Role of Phenotype Transition of Renal Tubular and Endothelial Cells.
    Contrib Nephrol 2018 23;192:48-55. Epub 2018 Jan 23.
    Division of Nephrology, Department of Internal Medicine, Ewha Woman's University College of Medicine, Ewha Medical Research Center, Seoul, Korea.
    Background: Although the clinical implication of hyperuricemia in chronic kidney disease has been an issue of active debate, recent data suggested a causative role of uric acid (UA) in the development of renal disease. Afferent arteriopathy, an induction of oxidative stress and an activation of local inflammation, have been regarded as the mechanisms of UA-induced renal disease, which contribute to glomerular hypertrophy and interstitial fibrosis via endothelial dysfunction. However, there have been rare studies on the direct effect of UA on phenotype transition of renal cells such as epithelial-to-mesenchymal transition (EMT) or endothelial-to-mesenchymal transition (EndoMT). Read More

    Renal Handling of Uric Acid.
    Contrib Nephrol 2018 23;192:1-7. Epub 2018 Jan 23.
    Hyperuricemia occurs in 21.4% of the adult population and is associated with several conditions that increase oxidative stress and contributes to the pathogenesis of inflammatory mechanisms for the development and progression of diseases. Serum blood or urine samples of uric acid levels were used to mainly identify clinical problems, depending on the uric acid pathway alterations, which include synthesis, reabsorption or its excretion. Read More

    Uric Acid: The Lower the Better?
    Contrib Nephrol 2018 23;192:69-76. Epub 2018 Jan 23.
    Background: Uric acid (UA) is still considered a risk factor, or even a causative agent, for chronic kidney disease (CKD); however, a few, important, clinical questions remain unanswered; in particular: when and whether urate-lowering therapy should be commenced in subjects with asymptomatic hyperuricemia and/or monosodium urate crystals deposition? What is the most appropriate UA target to be achieved and how long does it need to be maintained? How does treatment need be adjusted in patients with chronic kidney disease?

    Summary: The observational and intervention studies available do not fully answer such questions, and a treatment to target trial is required. We provide here some preliminary opinion on how such a trial might be designed. A final unresolved issue relates to the possible (if any) dangers of overtreatment of hyperuricemia, leading to "hypouricemia," which may occur more frequently with newer, more potent, drugs. Read More

    Renal Effects of Hyperuricemia.
    Contrib Nephrol 2018 23;192:8-16. Epub 2018 Jan 23.
    Department of Nephrology, General Hospital and Medical Unit Ambulatory Care, Mexican Institute of Social Security, Mexico City, Mexico.
    Background: From a clinical point of view, uric acid has been dismissed as a cause of injury and renal progression, and the mechanisms by which uric acid directly causes renal injury have not been fully understood. Hyperuricemia is associated with metabolic syndrome, diabetes, hypertension, and kidney and cardiovascular diseases. Although it remains controversial whether hyperuricemia is a causal factor for kidney disease, kidneys play a major role in the regulation of serum uric acid levels. Read More

    The Pathophysiology of Uric Acid on Renal Diseases.
    Contrib Nephrol 2018 23;192:17-24. Epub 2018 Jan 23.
    Laboratory of Renal Physiopathology, Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
    Background: Asymptomatic hyperuricemia was regarded as a marker and considered secondary to some pathological conditions such as hypertension. During the last 16 years, a vast amount of experimental work has shown that uric acid can cause intracellular alterations that lead to cardiovascular, renal, and metabolic disease. Epidemiological and clinical studies support this notion in specific populations. Read More

    Uric Acid: The Unknown Uremic Toxin.
    Contrib Nephrol 2018 23;192:25-33. Epub 2018 Jan 23.
    Uremic and Dialysis Clinic, México City, México.
    This review brings together concepts of uric acid metabolism affecting renal parenchyma and its function and the current therapies to reduce hyperuricemia (HyU) and avoid renal disease progression. High uric acid plays an important role in several chronic diseases including kidney diseases such as lithiasis, gout nephropathy, and preeclampsia. In the last 30 years, it has been shown that reducing HyU with low protein and low purine diets in addition to allopurinol creates physiopathological conditions that produce a slight increase in the glomerular filtration rate (GFR). Read More

    The Association between Serum Uric Acid and Renal Damage: The Takahata Study - New Insights.
    Contrib Nephrol 2018 23;192:34-40. Epub 2018 Jan 23.
    Background: Hyperuricemia is a risk factor for causing end-stage kidney disease and cardiovascular disease in the general population; however, several aspects, such as the site of kidney damaged by hyperuricemia and the threshold levels of serum uric acid for the development of renal damage, have not been fully clarified.

    Summary: To examine these aspects, we analyzed data from the Takahata study, a community-based cohort study involving participants of an annual health check-up, and used urinary albumin creatinine ratio (UACR) and urinary β2-microglobulin creatinine ratio (UBCR) in spot urine as indices of glomerular and tubular damage respectively. In cross-sectional analysis, increased serum uric acid levels were accompanied by higher UACR values and lower UBCR values. Read More

    Dietary patterns associated hyperuricemia among Chinese aged 45 to 59 years: An observational study.
    Medicine (Baltimore) 2017 Dec;96(50):e9248
    Department of Nutrition, Zhejiang Hospital, Xihu District, Hangzhou, Zhejiang, People's Republic of China.
    In our literature research, we have not found any study reporting the association between the major dietary patterns and the risk of hyperuricemia in a middle-aged Chinese population. Herein, the present study aimed to evaluate the association of dietary patterns with the risk of hyperuricemia in the city of Hangzhou, Zhejiang Province, East China. We included 1204 participants (743 males and 461 females) aged 45 to 59 years in the present cross-sectional study. Read More

    The association between serum uric acid and blood pressure in different age groups in a healthy Chinese cohort.
    Medicine (Baltimore) 2017 Dec;96(50):e8953
    Department of Geriatric Cardiology, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong Province, China.
    High serum uric acid (sUA) has been reported to be a risk factor for hypertension however, whether this is the case for all age groups is not clear. We examined the association between sUA concentrations and systolic and diastolic blood pressure (SBP and DBP) in different age groups in a cohort of healthy Chinese participants.A total of 1082 healthy participants aged from 41 to 70 years were included. Read More

    [Hyperuricaemia and Chronic Kidney Disease].
    G Ital Nefrol 2018 Feb;35(1)
    Cattedra di Nefrologia-Università degli studi della Campania "Luigi Vanvitelli"; P.O. S.M.d.P. Incurabili, Napoli.
    Hyperuricemia is defined as serum uric acid values greater than 6 mg/dl and could occur either due to hyperproduction or as a result of reduced renal excretion, which exceeds gut compensation. In Italy, prevalence is around 12% of the general population and increases in renal disease up to 60%. Recent experimental studies demonstrated a role of uric acid in the development of arterial hypertension and systemic arteriosclerosis, with an increase in cardiovascular risk. Read More

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