JoVE - Journal of Visualized Experiments
JoVE Visualize
Contact Us

Association of urinary excretion rates of uric acid with biomarkers of kidney injury in patients with advanced chronic kidney disease

  • 0División of Nephrology, A Coruña University Hospital, A Coruña, Spain.
Plos One +

|

June 11, 2024

|

June 11, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Urinary uric acid (UA) excretion, not blood levels, may better indicate kidney injury in chronic kidney disease (CKD) patients. This finding suggests urinary UA markers could be more sensitive for assessing urate-related kidney damage in advanced CKD.

Area Of Science

  • Nephrology
  • Urology
  • Biochemistry

Background

  • The role of hyperuricemia in chronic kidney disease (CKD) pathogenesis and progression is debated.
  • Current evidence suggests a modest correlation between serum uric acid (UA) and CKD progression, with limited success in urate-lowering therapies.
  • Urinary UA excretion may offer a more precise indicator of kidney injury related to urate levels.

Purpose Of The Study

  • To investigate the correlation between urinary uric acid (UA) excretion markers and kidney injury biomarkers in advanced CKD patients.
  • To determine if urinary UA excretion is a more accurate predictor of kidney injury than plasma UA levels.

Main Methods

  • Cross-sectional study of 120 advanced CKD patients (mean GFR 21.5 mL/min).
  • Assessed correlations between urinary UA excretion (total excretion, concentration, clearance, fractional excretion) and urinary kidney injury biomarkers (DKK3, KIM1, NGAL, IL-1b, MCP).
  • Utilized multivariate analysis, Spearman's rho correlation, and generalized additive models (GAM), controlling for confounding variables.

Main Results

  • Urinary UA concentrations, clearance, and fractional excretion independently correlated with kidney injury markers (DKK3, NGAL), unlike plasma UA or total 24-hour excretion.
  • Correlations were strongest for DKK3 and NGAL.
  • Glomerular filtration rate, proteinuria, statin use, and RAA axis antagonist treatment also independently correlated with kidney injury markers.

Conclusions

  • Urinary uric acid (UA) excretion rates appear to be a more accurate marker of UA-related kidney injury than plasma UA levels in advanced CKD.
  • Further longitudinal studies are required to establish the clinical significance of these findings.

Related Concept Videos

Factors Affecting Renal Clearance: Renal Impairment 01:17

84

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
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...

Renal Clearance 01:23

892

The glomerular filtration rate (GFR) is a critical marker of kidney function, reflecting the efficiency of filtration by the glomeruli. Renal clearance of specific substances, such as inulin or creatinine, is commonly used to measure GFR.
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers 01:19

77

Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...

Renal Failure: Dose Adjustments 01:11

84

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...

Physiology of Urine Formation 01:24

3.7K

Urine formation is an essential function of the human body. It plays a critical role in maintaining homeostasis by regulating the volume and composition of body fluids. The kidneys, the primary organs involved in this process, filter blood to remove waste products and excess substances, ultimately producing urine.
Glomerular Filtration
The first stage in urine formation is glomerular filtration. Each kidney contains approximately 1 million nephrons, the functional units of filtration, with a...

Determination of Renal Drug Clearance: Graphical and Midpoint Methods 01:07

109

Renal clearance, a crucial parameter in pharmacokinetics, can be determined using two different methods: the graphical method and the midpoint method. These methods provide insights into the rate of drug excretion by the kidneys and aid in assessing renal function.
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...