Abstract

Although hyperuricemia is shown to accelerate chronic kidney disease, the mechanisms remain unclear. Accumulating studies also indicate that uric acid has both pro- and antioxidant properties. We postulated that hyperuricemia impairs the function of glomerular podocytes, resulting in albuminuria. Hyperuricemic model was induced by oral administration of 2% oxonic acid, a uricase inhibitor. Oxonic acid caused a twofold increase in serum uric acid levels at 8 weeks when compared to control animals. Hyperuricemia in this model was associated with the increase in blood pressure and the wall-thickening of afferent arterioles as well as arcuate arteries. Notably, hyperuricemic rats showed significant albuminuria, and the podocyte injury marker, desmin, was upregulated in the glomeruli. Conversely, podocin, the key component of podocyte slit diaphragm, was downregulated. Structural analysis using transmission electron microscopy confirmed podocyte injury in this model. We found that urinary 8-hydroxy-2′-deoxyguanosine levels were significantly increased and correlated with albuminuria and podocytopathy. Interestingly, although the superoxide dismutase mimetic, tempol, ameliorated the vascular changes and the hypertension, it failed to reduce albuminuria, suggesting that vascular remodeling and podocyte injury in this model are mediated through different mechanisms. In conclusion, vasculopathy and podocytopathy may distinctly contribute to the kidney injury in a hyperuricemic state.

Highlights

  • Chronic kidney disease (CKD) continues to be a public health problem worldwide [1]

  • We recently showed that the effect of serum uric acid (UA) in the follow-up influenced the Oxidative Medicine and Cellular Longevity incipient end-stage renal disease (ESRD) by a propensity score analysis and that serum UA should be kept less than 6.5 mg/dL to inhibit the renal outcome [8]

  • We demonstrated that the experimental hyperuricemia induced by uricase inhibition is associated with podocyte injury and significant albuminuria

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Summary

Introduction

CKD causes end-stage renal disease (ESRD) and increases the prevalence of cardiovascular disease [2, 3] and, early intervention against the risk factors for CKD is crucial to improve renal and cardiovascular outcomes. Hyperuricemia has long been speculated as a possible risk factor of the incidence and progression of CKD over the last decade, but without reaching a broad consensus [4,5,6,7]. We recently showed that the effect of serum UA in the follow-up influenced the Oxidative Medicine and Cellular Longevity incipient ESRD by a propensity score analysis and that serum UA should be kept less than 6.5 mg/dL to inhibit the renal outcome [8]

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