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Association of uric acid with kidney function and albuminuria: the Uric Acid Right for heArt Health (URRAH) Project
BACKGROUND: Hyperuricemia is commonly observed in patients with chronic kidney disease (CKD). However, a better understanding of the relationship among uric acid (UA) values, glomerular filtration rate (GFR) and albuminuria may shed light on the mechanisms underlying the excess of cardiovascular mor...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803667/ https://www.ncbi.nlm.nih.gov/pubmed/33755930 http://dx.doi.org/10.1007/s40620-021-00985-4 |
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author | Russo, Elisa Viazzi, Francesca Pontremoli, Roberto Barbagallo, Carlo Maria Bombelli, Michele Casiglia, Edoardo Cicero, Arrigo Francesco Giuseppe Cirillo, Massimo Cirillo, Pietro Desideri, Giovambattista D’Elia, Lanfranco Ferri, Claudio Galletti, Ferruccio Gesualdo, Loreto Giannattasio, Cristina Iaccarino, Guido Leoncini, Giovanna Mallamaci, Francesca Maloberti, Alessandro Masi, Stefano Mengozzi, Alessandro Mazza, Alberto Muiesan, Maria Lorenza Nazzaro, Pietro Palatini, Paolo Parati, Gianfranco Rattazzi, Marcello Rivasi, Giulia Salvetti, Massimo Tikhonoff, Valérie Tocci, Giuliano Ungar, Andrea Verdecchia, Paolo Virdis, Agostino Volpe, Massimo Grassi, Guido Borghi, Claudio |
author_facet | Russo, Elisa Viazzi, Francesca Pontremoli, Roberto Barbagallo, Carlo Maria Bombelli, Michele Casiglia, Edoardo Cicero, Arrigo Francesco Giuseppe Cirillo, Massimo Cirillo, Pietro Desideri, Giovambattista D’Elia, Lanfranco Ferri, Claudio Galletti, Ferruccio Gesualdo, Loreto Giannattasio, Cristina Iaccarino, Guido Leoncini, Giovanna Mallamaci, Francesca Maloberti, Alessandro Masi, Stefano Mengozzi, Alessandro Mazza, Alberto Muiesan, Maria Lorenza Nazzaro, Pietro Palatini, Paolo Parati, Gianfranco Rattazzi, Marcello Rivasi, Giulia Salvetti, Massimo Tikhonoff, Valérie Tocci, Giuliano Ungar, Andrea Verdecchia, Paolo Virdis, Agostino Volpe, Massimo Grassi, Guido Borghi, Claudio |
author_sort | Russo, Elisa |
collection | PubMed |
description | BACKGROUND: Hyperuricemia is commonly observed in patients with chronic kidney disease (CKD). However, a better understanding of the relationship among uric acid (UA) values, glomerular filtration rate (GFR) and albuminuria may shed light on the mechanisms underlying the excess of cardiovascular mortality associated with both chronic kidney disease and hyperuricemia and lead to better risk stratification. Our main goal was to study the relationships between serum uric acid and kidney disease measures (namely estimated GFR [eGFR] and albuminuria) in a large cohort of individuals at cardiovascular risk from the URic acid Right for heArt Health (URRAH) Project database. METHODS: Clinical data of 26,971 individuals were analyzed. Factors associated with the presence of hyperuricemia defined on the basis of previously determined URRAH cutoffs for cardiovascular and all-cause mortality were evaluated through multivariate analysis. Chronic kidney disease was defined as eGFR < 60 ml/min per 1.73 m(2) and/or abnormal urinary albumin excretion diagnosed as: (i) microalbuminuria if urinary albumin concentration was > 30 and ≤ 300 mg/L, or if urinary albumin-to-creatinine ratio (ACR) was > 3.4 mg/mmol and ≤ 34 mg/mmol; (ii) macroalbuminuria if urinary albumin concentration was > 300 mg/L, or if ACR was > 34 mg/mmol. RESULTS: Mean age was 58 ± 15 years (51% males, 62% with hypertension and 12% with diabetes), mean eGFR was 81 ml/min per 1.73m2(2)with a prevalence of eGFR < 60 and micro- or macroalbuminuria of 16, 15 and 4%, respectively. Serum uric acid showed a trend towards higher values along with decreasing renal function. Both the prevalence of gout and the frequency of allopurinol use increased significantly with the reduction of eGFR and the increase in albuminuria. Hyperuricemia was independently related to male gender, eGFR strata, and signs of insulin resistance such as body mass index (BMI) and triglycerides. CONCLUSIONS: The lower the eGFR the higher the prevalence of hyperuricemia and gout. In subjects with eGFR < 60 ml/min the occurrence of hyperuricemia is about 10 times higher than in those with eGFR > 90 ml/min. The percentage of individuals treated with allopurinol was below 2% when GFR was above 60 ml/min, it increased to 20% in the presence of CKD 3b and rose further to 35% in individuals with macroalbuminuria. GRAPHIC ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40620-021-00985-4. |
format | Online Article Text |
id | pubmed-8803667 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-88036672022-02-02 Association of uric acid with kidney function and albuminuria: the Uric Acid Right for heArt Health (URRAH) Project Russo, Elisa Viazzi, Francesca Pontremoli, Roberto Barbagallo, Carlo Maria Bombelli, Michele Casiglia, Edoardo Cicero, Arrigo Francesco Giuseppe Cirillo, Massimo Cirillo, Pietro Desideri, Giovambattista D’Elia, Lanfranco Ferri, Claudio Galletti, Ferruccio Gesualdo, Loreto Giannattasio, Cristina Iaccarino, Guido Leoncini, Giovanna Mallamaci, Francesca Maloberti, Alessandro Masi, Stefano Mengozzi, Alessandro Mazza, Alberto Muiesan, Maria Lorenza Nazzaro, Pietro Palatini, Paolo Parati, Gianfranco Rattazzi, Marcello Rivasi, Giulia Salvetti, Massimo Tikhonoff, Valérie Tocci, Giuliano Ungar, Andrea Verdecchia, Paolo Virdis, Agostino Volpe, Massimo Grassi, Guido Borghi, Claudio J Nephrol Original Article BACKGROUND: Hyperuricemia is commonly observed in patients with chronic kidney disease (CKD). However, a better understanding of the relationship among uric acid (UA) values, glomerular filtration rate (GFR) and albuminuria may shed light on the mechanisms underlying the excess of cardiovascular mortality associated with both chronic kidney disease and hyperuricemia and lead to better risk stratification. Our main goal was to study the relationships between serum uric acid and kidney disease measures (namely estimated GFR [eGFR] and albuminuria) in a large cohort of individuals at cardiovascular risk from the URic acid Right for heArt Health (URRAH) Project database. METHODS: Clinical data of 26,971 individuals were analyzed. Factors associated with the presence of hyperuricemia defined on the basis of previously determined URRAH cutoffs for cardiovascular and all-cause mortality were evaluated through multivariate analysis. Chronic kidney disease was defined as eGFR < 60 ml/min per 1.73 m(2) and/or abnormal urinary albumin excretion diagnosed as: (i) microalbuminuria if urinary albumin concentration was > 30 and ≤ 300 mg/L, or if urinary albumin-to-creatinine ratio (ACR) was > 3.4 mg/mmol and ≤ 34 mg/mmol; (ii) macroalbuminuria if urinary albumin concentration was > 300 mg/L, or if ACR was > 34 mg/mmol. RESULTS: Mean age was 58 ± 15 years (51% males, 62% with hypertension and 12% with diabetes), mean eGFR was 81 ml/min per 1.73m2(2)with a prevalence of eGFR < 60 and micro- or macroalbuminuria of 16, 15 and 4%, respectively. Serum uric acid showed a trend towards higher values along with decreasing renal function. Both the prevalence of gout and the frequency of allopurinol use increased significantly with the reduction of eGFR and the increase in albuminuria. Hyperuricemia was independently related to male gender, eGFR strata, and signs of insulin resistance such as body mass index (BMI) and triglycerides. CONCLUSIONS: The lower the eGFR the higher the prevalence of hyperuricemia and gout. In subjects with eGFR < 60 ml/min the occurrence of hyperuricemia is about 10 times higher than in those with eGFR > 90 ml/min. The percentage of individuals treated with allopurinol was below 2% when GFR was above 60 ml/min, it increased to 20% in the presence of CKD 3b and rose further to 35% in individuals with macroalbuminuria. GRAPHIC ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40620-021-00985-4. Springer International Publishing 2021-03-23 2022 /pmc/articles/PMC8803667/ /pubmed/33755930 http://dx.doi.org/10.1007/s40620-021-00985-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Russo, Elisa Viazzi, Francesca Pontremoli, Roberto Barbagallo, Carlo Maria Bombelli, Michele Casiglia, Edoardo Cicero, Arrigo Francesco Giuseppe Cirillo, Massimo Cirillo, Pietro Desideri, Giovambattista D’Elia, Lanfranco Ferri, Claudio Galletti, Ferruccio Gesualdo, Loreto Giannattasio, Cristina Iaccarino, Guido Leoncini, Giovanna Mallamaci, Francesca Maloberti, Alessandro Masi, Stefano Mengozzi, Alessandro Mazza, Alberto Muiesan, Maria Lorenza Nazzaro, Pietro Palatini, Paolo Parati, Gianfranco Rattazzi, Marcello Rivasi, Giulia Salvetti, Massimo Tikhonoff, Valérie Tocci, Giuliano Ungar, Andrea Verdecchia, Paolo Virdis, Agostino Volpe, Massimo Grassi, Guido Borghi, Claudio Association of uric acid with kidney function and albuminuria: the Uric Acid Right for heArt Health (URRAH) Project |
title | Association of uric acid with kidney function and albuminuria: the Uric Acid Right for heArt Health (URRAH) Project |
title_full | Association of uric acid with kidney function and albuminuria: the Uric Acid Right for heArt Health (URRAH) Project |
title_fullStr | Association of uric acid with kidney function and albuminuria: the Uric Acid Right for heArt Health (URRAH) Project |
title_full_unstemmed | Association of uric acid with kidney function and albuminuria: the Uric Acid Right for heArt Health (URRAH) Project |
title_short | Association of uric acid with kidney function and albuminuria: the Uric Acid Right for heArt Health (URRAH) Project |
title_sort | association of uric acid with kidney function and albuminuria: the uric acid right for heart health (urrah) project |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803667/ https://www.ncbi.nlm.nih.gov/pubmed/33755930 http://dx.doi.org/10.1007/s40620-021-00985-4 |
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