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Impact of Serum Uric Acid Levels on Outcomes following Renal Artery Revascularization in Patients with Renovascular Disease

BACKGROUND: Percutaneous transluminal renal angioplasty (PTRA) improves blood pressure (BP) and renal function only in selected patients with atherosclerotic renovascular disease (ARVD). Hyperuricemia is associated with elevated risk for hypertension and chronic renal disease, but its role in renova...

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Autores principales: Chen, Xiao-jun, Eirin, Alfonso, Kane, Garvan C., Misra, Sanjay, Textor, Stephen C., Lerman, Amir, Lerman, Lilach O.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374789/
https://www.ncbi.nlm.nih.gov/pubmed/30838132
http://dx.doi.org/10.1155/2019/3872065
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author Chen, Xiao-jun
Eirin, Alfonso
Kane, Garvan C.
Misra, Sanjay
Textor, Stephen C.
Lerman, Amir
Lerman, Lilach O.
author_facet Chen, Xiao-jun
Eirin, Alfonso
Kane, Garvan C.
Misra, Sanjay
Textor, Stephen C.
Lerman, Amir
Lerman, Lilach O.
author_sort Chen, Xiao-jun
collection PubMed
description BACKGROUND: Percutaneous transluminal renal angioplasty (PTRA) improves blood pressure (BP) and renal function only in selected patients with atherosclerotic renovascular disease (ARVD). Hyperuricemia is associated with elevated risk for hypertension and chronic renal disease, but its role in renovascular hypertension is unclear. We hypothesized that hyperuricemia negatively impacts renal and BP outcomes among patients with ARVD undergoing PTRA. METHODS: This retrospective, observational cohort study included 94 patients with ARVD and preserved systolic cardiac function, who underwent PTRA at Mayo Clinic, Rochester, Minnesota. Renal, BP, and mortality outcomes were compared among patients according to their serum uric acid (SUA) levels. Multivariate analysis was used to determine significant predictors of renal, BP, and mortality outcomes after PTRA. RESULTS: Compared to patients with normal basal SUA levels (≤5.7 mg/dl), patients with very high SUA (≥8.7 mg/dl) had lower baseline estimated glomerular filtration rate (eGFR), more extensive use of antihypertensive and diuretic drugs, increased baseline systolic blood pressure (SBP), and elevated left ventricular mass index. After PTRA, multiple logistic regression analysis showed that, compared to normal SUA, very high SUA was associated with decreased odds ratio (OR) of change in eGFR (adjusted OR=0.90; 95% confidence interval [CI], 0.86-0.95), but not of change in SBP. In multivariate linear analysis SUA independently predicted delta urine protein/creatinine ratio (β: 26.0; 95% confidence interval, 13.9 to 38.1). CONCLUSION: Severe hyperuricemia in patients with AVRD may have a negative impact on outcomes of renal revascularization.
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spelling pubmed-63747892019-03-05 Impact of Serum Uric Acid Levels on Outcomes following Renal Artery Revascularization in Patients with Renovascular Disease Chen, Xiao-jun Eirin, Alfonso Kane, Garvan C. Misra, Sanjay Textor, Stephen C. Lerman, Amir Lerman, Lilach O. Int J Hypertens Research Article BACKGROUND: Percutaneous transluminal renal angioplasty (PTRA) improves blood pressure (BP) and renal function only in selected patients with atherosclerotic renovascular disease (ARVD). Hyperuricemia is associated with elevated risk for hypertension and chronic renal disease, but its role in renovascular hypertension is unclear. We hypothesized that hyperuricemia negatively impacts renal and BP outcomes among patients with ARVD undergoing PTRA. METHODS: This retrospective, observational cohort study included 94 patients with ARVD and preserved systolic cardiac function, who underwent PTRA at Mayo Clinic, Rochester, Minnesota. Renal, BP, and mortality outcomes were compared among patients according to their serum uric acid (SUA) levels. Multivariate analysis was used to determine significant predictors of renal, BP, and mortality outcomes after PTRA. RESULTS: Compared to patients with normal basal SUA levels (≤5.7 mg/dl), patients with very high SUA (≥8.7 mg/dl) had lower baseline estimated glomerular filtration rate (eGFR), more extensive use of antihypertensive and diuretic drugs, increased baseline systolic blood pressure (SBP), and elevated left ventricular mass index. After PTRA, multiple logistic regression analysis showed that, compared to normal SUA, very high SUA was associated with decreased odds ratio (OR) of change in eGFR (adjusted OR=0.90; 95% confidence interval [CI], 0.86-0.95), but not of change in SBP. In multivariate linear analysis SUA independently predicted delta urine protein/creatinine ratio (β: 26.0; 95% confidence interval, 13.9 to 38.1). CONCLUSION: Severe hyperuricemia in patients with AVRD may have a negative impact on outcomes of renal revascularization. Hindawi 2019-01-30 /pmc/articles/PMC6374789/ /pubmed/30838132 http://dx.doi.org/10.1155/2019/3872065 Text en Copyright © 2019 Xiao-jun Chen et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Chen, Xiao-jun
Eirin, Alfonso
Kane, Garvan C.
Misra, Sanjay
Textor, Stephen C.
Lerman, Amir
Lerman, Lilach O.
Impact of Serum Uric Acid Levels on Outcomes following Renal Artery Revascularization in Patients with Renovascular Disease
title Impact of Serum Uric Acid Levels on Outcomes following Renal Artery Revascularization in Patients with Renovascular Disease
title_full Impact of Serum Uric Acid Levels on Outcomes following Renal Artery Revascularization in Patients with Renovascular Disease
title_fullStr Impact of Serum Uric Acid Levels on Outcomes following Renal Artery Revascularization in Patients with Renovascular Disease
title_full_unstemmed Impact of Serum Uric Acid Levels on Outcomes following Renal Artery Revascularization in Patients with Renovascular Disease
title_short Impact of Serum Uric Acid Levels on Outcomes following Renal Artery Revascularization in Patients with Renovascular Disease
title_sort impact of serum uric acid levels on outcomes following renal artery revascularization in patients with renovascular disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374789/
https://www.ncbi.nlm.nih.gov/pubmed/30838132
http://dx.doi.org/10.1155/2019/3872065
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