The Role of Uric Acid in Acute Kidney Injury
| Autor: | Thomas M. Beaver, Rajesh Mohandas, Richard J. Johnson, Vijay Lapsia, Bhagwan Dass, Michiko Shimada, A. Ahsan Ejaz, Kawther F. Alquadan |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
030232 urology & nephrology Renal function Hyperuricemia 030204 cardiovascular system & hematology urologic and male genital diseases Gastroenterology Diabetic nephropathy 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine Rasburicase Humans Likelihood Functions business.industry Acute kidney injury Acute Kidney Injury medicine.disease Uric Acid chemistry Uric acid Female Metabolic syndrome business Kidney disease medicine.drug |
| Zdroj: | Nephron. 142(4) |
| ISSN: | 2235-3186 |
| Popis: | Studies have demonstrated the presence of a strong association between serum uric acid (SUA) and acute kidney injury (AKI) consistently across several disease models. Exposure to SUA at different time periods and concentrations has reliably resulted in AKI whether assessed by conventional or novel biomarkers or by kinetic estimated glomerular filtration rate (KeGFR) engineered for non-steady dynamic states. In experimental models, moderate hyperuricemia was associated with an absence of intrarenal crystals, manifestation of tubular injury, macrophage infiltration, and increased expression of inflammatory mediators that were attenuated with uric acid lowering therapy with rasburicase, a recombinant urate oxidase. In a pilot clinical trial, treatment with rasburicase was associated with a decreased incidence of AKI and evidence for less renal structural injury. Lowering SUA also improved KeGFR and estimated glomerular filtration rate in 2 separate studies. SUA has also been linked to diabetic nephropathy, hypertension, cardiovascular disease, chronic kidney disease, metabolic syndrome, and their mechanisms of action share many common traits. In this article, we explore the evidence for the causal role of SUA in AKI using Bradford Hill criteria as a guideline with data integration from related fields. |
| Databáze: | OpenAIRE |
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