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Is there association between uric acid and inflammation in hemodialysis patients?
Julie Calixto Lobo1, Milena Barcza Stockler-Pinto, Antonio Claudio Lucas da Nóbrega
1Program in Cardiovascular Sciences, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil.
Insights
Elevated uric acid levels in hemodialysis patients correlate with increased inflammation and atherosclerosis markers. This suggests uric acid may play a role in these conditions, warranting further investigation.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Immunology
Background:
- Elevated serum uric acid is linked to cardiovascular disease and inflammation.
- High uric acid levels are prevalent in chronic kidney disease (CKD) patients.
- The role of uric acid in the inflammatory state of CKD, particularly in hemodialysis (HD) patients, requires further exploration.
Purpose of the Study:
- To investigate the association between serum uric acid levels and inflammatory markers in hemodialysis patients.
- To analyze the relationship between uric acid and markers of inflammation and atherosclerosis in this population.
Main Methods:
- A cross-sectional study was conducted with 50 hemodialysis patients and 21 healthy controls.
- Serum uric acid, inflammatory markers (TNF-α, IL-6, CRP), and atherosclerosis markers (ICAM-1, VCAM-1, MCP-1, PAI-1) were measured.
- Statistical analysis was performed to determine correlations between uric acid and inflammatory/atherosclerosis markers.
Main Results:
- Hemodialysis patients exhibited significantly higher levels of inflammatory markers (TNF-α, IL-6, CRP) and atherosclerosis markers (VCAM-1, ICAM-1) compared to healthy individuals.
- Uric acid levels were also significantly higher in hemodialysis patients than in the control group.
- A positive correlation was observed between uric acid levels and several inflammatory markers, including IL-6, CRP, and TNF-α, as well as atherosclerosis markers ICAM-1 and VCAM-1.
Conclusions:
- The findings suggest a potential role for uric acid in promoting inflammation and atherosclerosis in hemodialysis patients.
- Further prospective studies and intervention trials are necessary to establish a causal relationship between uric acid and these markers.
Background:
Elevated serum uric acid has been associated with a variety of cardiovascular disease and with inflammation, but these have been little explored in chronic kidney disease (CKD). Elevated uric acid levels are common in CKD patients and could be involved in inflammatory milieu; our aim was to analyze the association between uric acid and inflammatory markers in hemodialysis (HD) patients.
Design:
This was a cross-sectional study.
Setting:
This study was conducted from private clinic, Rio de Janeiro, Brazil.
Patients:
This study included 50 HD patients and 21 healthy subjects.
Methods And Procedures:
This study included 50 HD patients [62% men, 54.3 ± 12.6 years, 57.5 ± 50.1 months on dialysis, and body mass index (BMI), 24.4 ± 4.1 kg/m2] and 21 healthy individuals (45% men, 50.7 ± 15.7 years and BMI, 25.5 ± 4 kg/m2). Uric acid was measured using uricase-PAP method; inflammatory [tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP)] and atherosclerosis markers [intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), monocyte chemoattractant protein-1 (MCP-1), plasminogen activator inhibitor-1 (PAI-1)] were measured by a multiplexed assay.
Results:
PATIENTS presented high levels of TNF-α, IL-6, CRP, VCAM-1, ICAM-1 (5.5 ± 2.1 pg/mL, 4.1 ± 1.6 pg/mL, 0.32 ± 0.30 mg/mL, 48.5 ± 8.5 ng/mL, 20.5 ± 15.9 ng/mL, respectively), compared with healthy individuals (2.4 ± 1.1 pg/mL, 2.7 ± 0.4 pg/mL, 0.11 ± 0.12 mg/mL, 23.8 ± 5.5 ng/mL, 7.2 ± 1.2 ng/mL, respectively) ( p < 0.04). Uric acid levels were also higher in HD patients (5.4 ± 1.3 mg/dL) than in healthy individuals (3.9 ± 0.9 mg/dL) ( p < 0.02). There was a positive correlation between uric acid and inflammatory markers, IL-6 (r = 0.30, p = 0.01), CRP (r = 0.37, p = 0.003), TNF-α (r = 0.40, p = 0.001), ICAM-1 (r = 0.53, p = 0.0001), and VCAM-1 (r = 0.45, p = 0.0001).
Conclusion:
These original data suggest that uric acid may have a role in inflammation and atherosclerosis in HD patients. However, further prospective studies involving intervention trials should be conducted in order to search for actual causality relationship between these markers.
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