Serum uric acid and the risk of cardiovascular and renal disease
![Quantitative SERS Detection of Uric Acid via Formation of Precise Plasmonic Nanojunctions within Aggregates of Gold Nanoparticles and Cucurbit[n]uril](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F61682.jpg&w=3840&q=50)
Claudio Borghi1, Enrico Agabiti Rosei, Thomas Bardin
1aDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy bDepartment of Clinical and Experimental Sciences, University of Brescia, Department of Medicine, Spedali Civili, Brescia, Italy cAssistance Publique Hôpitaux de Paris, Hôpital Lariboisière dUniversité Paris Diderot, Sorbonne Paris Cité eINSERM, UMR 1132, Paris, France fInstitute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK gDepartment of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany hCardiology Department, Asklepeion Hospital, Athens, Greece iRheumatology Division, Hospital Universitario Cruces and Biocruces Health Research Institute, Vizcaya, Spain jUniversità Milano-Bicocca, IRCCS Istituto Auxologico Italiano, Milan, Italy.
Insights
Chronic hyperuricemia (high serum uric acid) independently risks hypertension, metabolic syndrome, CKD, and cardiovascular disease. Lowering uric acid may improve outcomes, even without gout.
Area of Science:
- Nephrology
- Cardiology
- Metabolic Diseases
Background:
- Chronic hyperuricemia is an independent risk factor for hypertension, metabolic syndrome, chronic kidney disease (CKD), and cardiovascular diseases.
- Serum uric acid levels above 6 mg/dl are considered abnormal, necessitating greater attention in patient profiling.
- The potential benefits of lowering serum uric acid on cardiovascular and renal outcomes require further investigation.
Purpose of the Study:
- To review the evidence on chronic hyperuricemia as a risk factor for major non-gout related diseases.
- To evaluate the efficacy of urate-lowering therapies on cardiovascular and renal outcomes.
- To explore the therapeutic mechanisms and clinical benefits of urate-lowering drugs, particularly xanthine oxidase inhibitors.
Main Methods:
- Literature review of studies investigating the association between hyperuricemia and cardiovascular/renal diseases.
- Analysis of clinical trial data on the effects of urate-lowering drugs on patient outcomes.
- Examination of the mechanisms of action of xanthine oxidase inhibitors in managing hyperuricemia.
Main Results:
- Substantial evidence links chronic hyperuricemia to increased risk of hypertension, metabolic syndrome, CKD, and cardiovascular diseases.
- A trend toward improved cardiovascular and renal outcomes is observed with urate-lowering drug administration, especially xanthine oxidase inhibitors.
- Urate-lowering therapy may offer benefits beyond gout management, including in patients with urate deposition, advanced CKD, or cardiovascular risk factors.
Conclusions:
- Chronic hyperuricemia is a significant independent risk factor for multiple non-gout related conditions.
- Lowering serum uric acid levels, particularly with xanthine oxidase inhibitors, shows promise for improving cardiovascular and renal outcomes.
- Urate-lowering therapy should be considered for patients with hyperuricemia, even in the absence of overt gout, especially when associated with CKD or cardiovascular risk factors.
Abstract:
Substantial evidence suggests that chronic hyperuricemia is an independent risk factor for hypertension, metabolic syndrome, chronic kidney disease (CKD) and cardiovascular diseases. This highlights the need for greater attention to serum uric acid levels when profiling patients, and suggests that the threshold above which uricemia is considered abnormal is 6 mg/dl, in light of the available evidence. Another important question is whether lowering serum uric acid can improve cardiovascular and renal outcomes, and what therapeutic mechanism of action could provide more clinical benefits to patients; the available literature shows a trend toward improvement associated with administration of urate-lowering drugs, in particular for the xanthine oxidase inhibitors. The demonstrated efficacy of urate-lowering therapy on outcomes other than gout flares leads to the consideration that treatment may be beneficial even in the absence of overt gout when hyperuricemia accompanies other clinical conditions, such as urate deposition, advanced CKD or cardiovascular risk factors.
Related Concept Videos
01:24Serum Studies: Renal Function Tests
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:24Chronic Kidney Disease II: Clinical Manifestations
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration