Decrease In Uric Acid Levels Research Articles

Effect of giving rosella flower extract (hibiscus sabdariffa) after physical exercise on uric acid levels in healthy men

The aim of this study was to test whether rosella flower extract can reduce uric acid levels after physical activity. Pre- and post-control groups were used in this experimental investigation. Purposive sampling was used to select the individuals, and once they were chosen, they were split into two groups: the treatment group (P) received 500 mg of rosella flower extract, and the control group (K) received a placebo. A total of 20 healthy men aged 19-25 years participated in this study. Data collection was carried out for 1 day starting with collecting data on subject characteristics. After that, the subjects were asked to warm up. Physical activity was carried out afterwards. The activity included running 2400 meters with moderate intensity. Then the baseline data was taken by checking uric acid levels. Then the samples were given a placebo and rosella flower extract to drink directly. 60 minutes later the post-test uric acid level data was taken. The results of this study showed that there was a decrease in uric acid levels in both the control and treatment groups. However, a significant decrease occurred in the group with 500 mg of rosella flower extract intervention. Given its high antioxidant content, we recommend consuming roselle flower extract as an additional supplement after exercise.

Drug-Induced Hypouricemia.

Hypouricemia is defined as a serum uric acid concentration of ≤ 2.0mg/dL or 119μmol/L. Hypouricemia may occur secondarily to a number of underlying conditions, including severe hepatocellular disease, neoplasia, defective renal tubular reabsorption of uric acid, inherited metabolic defect in purine metabolism, and drugs. Medications are an important cause of hypouricemia. They can cause hypouricemia by a variety of mechanisms. Drug-induced hypouricemia mostly occurs as overtreatment of hyperuricemia by urate-lowering therapies including xanthine oxidase inhibitors, uricosuric agents and uricases. Drugs not used in the treatment of gout may also lead to a decrease of uric acid levels. In this literature review, medications leading to hypouricemia are summarized with regard to their mechanism of action and clinical significance.

Penerapan Senam Ergonomis Terhadap Penurunan Kadar Asam Urat pada Lansia di Desa Pondok Sukoharjo

Background: Gout is a disease associated with high levels of uric acid in the blood. Apart from the aging process, gout can also occur due to the inhibition of the secretion process and a decrease in the enzyme uricase. The aging process in the elderly causes various health problems, as a result of which they are susceptible to diseases, one of which is an increase in uric acid. Uric acid numbers can be said to be abnormal if >6 mg/dl for women and >7.2 mg/dl for men. Non-pharmacological therapy that can be done is ergonomic exercise. The purpose of this study is to compare measurements of uric acid levels before and after ergonomic exercise. Methods: A case study of 2 respondents was conducted three times a week, with a duration of 19 minutes for each exercise. Results: The application of the two respondents resulted in a significant decrease in uric acid levels; namely, Mrs. S obtained a result of 4.8 mg/dl, while Mrs. T obtained a result of 5 mg/dl. Conclusion: The results of this study concluded that there was a decrease in uric acid levels in both respondents after ergonomic gymnastics.

The Effect of Pumpkin Seeds (Cucurbita moschata) on Uric Acid Level in Hyperuricemia Patients

Background: Hyperuricemia is a condition in which uric acid level exceeds normal threshold. The pumpkin seed extract contains flavonoids that can lower uric acid level. This study aims to analyze the effect of pumpkin seeds (Cucurbita moschata) capsules compared to allopurinol on uric acid level in hyperuricemia patients. Methods: This was an experimental research with a non-randomized control group pretest-posttest design. A total of 63 patients (32 intervention and 31 control) with hyperuricemia enrolled in this study through purposive sampling technique. The intervention group (IG) was given pumpkin seeds and control group (CG), allopurinol. Data were analyzed using paired and independent sample t-test. Results: The result of this study showed that uric acid level significantly decreased after the pumpkin seed capsule was provided (Mean changes=-0.33 mg,dl; P<0.001). However, allopurinol played a greater role in lowering uric acid levels (Mean changes=-0.92 mg/dl; P<0.001). The mean changes of uric acid between groups was also significant (P=0.039). In addition, some of the nutrition intakes showed a significant difference after the intervention. Conclusion: It can be concluded from the study that pumpkin seed capsules affected the decrease of uric acid level significantly, but the number was lower compared to allopurinol. In future studies, The dose of pumpkin seed should be considered.

Cardiometabolic Risk Factors Related to Atrial Fibrillation and Metabolic Syndrome in the Pakistani Population.

Background and Objectives: This study aimed to examine the relationship between cardiometabolic risk factors and atrial fibrillation (AF) and the simultaneous presence of AF and metabolic syndrome (MetS) in the Pakistani population. Materials and Methods: A total of 690 subjects were enrolled (n = 230 patients with AF, n = 230 patients with AF and MetS, and n = 230 controls). The associations between cardiometabolic parameters and AF with and without MetS were analyzed by univariable and multivariable binary regression analyses. Results: Body mass index (BMI), fasting blood glucose (FBG), and triglycerides (TG) were independently positively correlated, but the glomerular filtration rate (GFR) and sodium were independently negatively correlated with AF. An increase in BMI, FBG, and TG levels by one unit measure increased the probability by 55.1%, 20.6%, and 1.3%, respectively, for the AF occurrence. A decrease in GFR and sodium levels increased the probability by 4.3% and 33.6%, respectively, for the AF occurrence. On the other hand, uric acid was independently negatively correlated, whereas sodium was independently positively correlated, with MetS and AF. A decrease in uric acid levels and an increase in sodium levels by 1 unit measure increased the probability for MetS and AF by 23.2% and 7.5%, respectively. Conclusions: Cost-effective and routinely measured parameters, i.e., BMI, FBG TG, GFR, and sodium levels, can be reliable indicators of AF, whereas serum uric acid and sodium levels are independently associated with AF and MetS in the Pakistani population. Timely recognition and the control of modifiable cardiometabolic risk factors are of great significance in the prevention of AF development.

#1135 Evaluation of the adequacy of urate lowering therapy prescriptions in patients with chronic kidney disease: results from the CKD-REIN cohort

Abstract Background and Aims Urate Lowering Therapy (ULT) is frequently prescribed to patients with chronic kidney disease (CKD). However, these prescriptions are often inadequate when considering kidney function. Studies evaluating the appropriateness of ULT in the CKD population are predominantly cross-sectional. Yet, the evolution and reassessment of prescriptions remain unexplored in this context. This study aims to assess the prevalence of inappropriate ULT prescriptions (whether contraindications or inappropriately high doses) with regard to kidney function in patients with CKD. Method We used 5-year longitudinal data from the CKD-REIN cohort, a nationwide sample of 3033 nephrology outpatients with moderate-to-advanced CKD. Prescriptions for colchicine, used in the treatment of acute gout attacks, and ULT, such as allopurinol and febuxostat, were prospectively recorded. An inappropriate prescription was defined as the reported prescription of either a contraindicated drug, an indicated drug at an inappropriately high dose level, or a non-recommended prescription relative to the patient's eGFR, as estimated with de-indexed CKD-EPI equation and according to the European (or French if not available) summary of product characteristics. For patients initiating ULT during follow-up, uric acid levels were compared six months before and after the initiation of ULT. Results At baseline, 987 (33%) out of the 3033 included patients (mean ± standard deviation age 67 ± 13 years, 65% men) were prescribed ULT, with 781 (26%) receiving allopurinol and 206 (7%) receiving febuxostat. Compared to patients without a prescription for ULT, those with a ULT prescription were more frequently male, older, had lower kidney function, higher cardiovascular comorbidities, and were more commonly prescribed diuretics and inhibitors of the renin-angiotensin system. Moreover, their uric acid levels were lower (patients with ULT prescription 377.0 ± 110.4 µmol/L versus without ULT prescription 456.5 ± 116.4 µmol/L, p < 0.001). Notably, 316 (40%) allopurinol prescriptions were prescribed at inappropriately high dosages, while 77 (37%) febuxostat prescriptions were not recommended (resulting in a total of 393 (40%) inappropriate ULT prescriptions at baseline). Of the 54 colchicine prescriptions, one-third (n = 18) were contraindicated according to kidney function and nine were prescribed “on-demand” for crisis anticipation. During a median follow-up of 5.0 [1st-3rd quartile, 4.0–5.1] years, 253 patients were newly prescribed allopurinol and 176 were newly prescribed febuxostat, 54 (21%) out of 253 new allopurinol prescriptions were at inappropriately high dosages, and 68 (39%) out of the 176 new febuxostat prescriptions were not recommended based on the patient's kidney function (Figure). The majority of initially inappropriate ULT prescriptions (n = 393) remained so during follow-up (274 (70%)). Among the 179 patients initiating ULT during follow-up and with available data on uric acid levels, there was a significant decrease in uric acid levels after ULT initiation compared to before initiation (before: 494.5 ± 146.2 µmol/L versus after 408.5 ± 130.9 µmol/L, p < 0.001). A total of 197 patients had initiated colchicine during follow-up, with 61 (31%) receiving contraindicated prescriptions, and 18 (9%) having “on-demand” prescriptions. Conclusion Our findings emphasize the lack of reassessment of ULT prescriptions during the follow-up of patients with CKD. Colchicine prescriptions in case of severe kidney impairment persist despite contraindications. Further evaluation is required to understand the association between ULT prescriptions and the progression of kidney disease.

Endocrinological aspects of gout

Gout is the most common inflammatory joint disease, and its incidence increases with age and the presence of certain diseases, primarily obesity and chronic kidney disease, as well as while taking certain medications. Treatment of a patient with gout requires the interaction of a rheumatologist, cardiologist and endocrinologist, and even better, a well-trained therapist who is able to independently supervise gout-related diseases without the involvement of specialized specialists. This review was written to highlight current data on the most common endocrinopathies in gout for practitioners. The data presented indicate the existence of a relationship between gout and various endocrine diseases. The most important aspect is the presence of metabolic syndrome in most patients with gout, the treatment of which also requires taking into account the effect of prescribed drugs on purine metabolism. On the other hand, effects on certain endocrinological diseases can lead to improved purine metabolism. It has been shown that weight loss, including through bariatric means, is accompanied by a decrease in uric acid levels and may be accompanied by a decrease in the need for urate-lowering therapy. Most glucose-lowering drugs affect purine metabolism, and the presence of concomitant gout may determine the specific choice of antidiabetic therapy. Menopause is characterized by an increase in uric acid levels and the incidence of gout. At the same time, the use of menopausal hormone therapy may be accompanied by both a decrease in uric acid levels and the risk of developing gout. Despite the fact that an increase in testosterone levels in men is positively correlated with uric acid levels, its deficiency is accompanied not by a decrease, but by an increase in uric acid levels.

Bioactivity of <i>Lantana camara</i> Flowers: Antilithiatic and Nephroprotective Implications in Male Wistar Rats

Lantana camara is a well-known medicinal plant with various reported therapeutic compounds. This study explores the antilithiatic and nephroprotective effects of Lantana camara flower hydroalcoholic extract. Using animal models and cell culture, we assessed its impact on ethylene glycol-induced nephrolithiasis and gentamicin-induced nephrotoxicity. The ethylene glycol-induced nephrolithiasis model revealed elevated levels of calcium, phosphate, and oxalate, indicating the formation of calculi. Treatment with the hydroalcoholic extract resulted in a significant decrease in uric acid levels, reducing the likelihood of calculi formation. Additionally, the animals treated with the extract showed reduced levels of urea, and creatinine, indicating improved kidney function. The results highlighted the notable difference between the preventive and curative treatments. In the HEK-293 cell culture, the hydroalcoholic extract demonstrated a significant inhibition of abnormal cell morphology induced by gentamicin, a nephrotoxic drug. The extract also exhibited a marked improvement in cell growth compared to the standard treatment. The findings of this study provide substantial evidence supporting the antilithiatic and nephroprotective effects of the hydroalcoholic extract of Lantana camara flowers. The extract effectively reduced the risk of calculi formation, improved renal parameters, and demonstrated potential in mitigating drug-induced nephrotoxicity. These results validate the traditional claims regarding the efficacy of Lantana camara as a therapeutic agent for kidney-related disorders. The hydroalcoholic extract of Lantana camara flowers could serve as a valuable alternative treatment option, offering potential benefits in the management of lithiasis and nephrotoxicity.

Antihyperurisemia Activity of Etanol Extract of Etlingera rubroloba A.D Poulsen Fruits on Uric Acid and Cyclooxygenase-2 Levels In Vivo

Etlingera rubroloba A.D Poulsen (E. rubroloba) plants from the genus Etlingera, empirically used as traditional medicine by several ethnicities in Southeast Sulawesi, namely to increase endurance and relieve joint pain. The purpose of this study was to determine the antihyperuricemia activity on uric acid levels and cyclooxygenase-2 (COX-2) levels in vivo in mice. This study used six groups of test animals consisting of normal, negative (Na-CMC) 0.5%, positive control (allopurinol) and dose groups of ethanol extract of E. rubroloba fruit 100, 200 and 300 mg/g bw. Modeling of hyperuricemia test animals is done by inducing potassium oxonate. Measurement of uric acid levels by lateral chromatography method and COX-2 levels by ELISA method. The results showed that ethanol extract of E. rubroloba fruit can reduce uric acid and COX-2 levels (p<0.05). The results of the correlation statistical test showed a positive correlation between uric acid levels and COX-2 levels, where the decrease in uric acid levels was directly proportional to the decrease in COX-2 levels. This research can be a reference in the development of traditional medicine, especially anti-hyperuricemia.

Correlation Between Impaired Sensitivity to Thyroid Hormones and Serum Uric Acid in Female Patients With Obesity and After Laparoscopic Sleeve Gastrectomy

ObjectiveAn alterable risk factor for hyperuricemia is obesity. Additionally, obese people may have a moderate form of acquired resistance to thyroid hormones. Thyrotropin, thyroid hormones, and obesity all interact subtly. However, the connection between thyroid hormone sensitivity and hyperuricemia in obese patients both before and after laparoscopic sleeve gastrectomy (LSG) has not yet been clarified. The objective of our study was to investigate the connection between impaired thyroid hormone sensitivity and elevated uric acid (UA) levels before and after LSG. MethodsIn total, 1054 euthyroid patients with obesity (481 males, 573 females), 248 (143 female patients) of whom underwent subsequent LSG, were enrolled in this retrospective study. Anthropometric measurements and thyroid hormone and UA levels were taken before and 3 months after LSG. ResultsFemale patients with obesity with impaired sensitivity to thyroid hormones had higher UA levels (P for trend <.01). The odds ratio of the fourth vs first quartile of thyroid feedback quantile index, thyrotropin index, and thyrotropin-thyroxine resistance index were 4.285 (confidence interval: 1.360-13.507), 3.700 (confidence interval: 1.276-10.729), and 2.839 (confidence interval: 1.014-7.948), respectively, with robust relationships with female hyperuricemia (all P < .05). However, there was only a positive correlation between the decline in UA levels and thyroid feedback quantile index, thyrotropin, and thyrotropin-thyroxine resistance index in female patients following LSG. ConclusionFemale hyperuricemia is correlated with higher thyroid hormone resistance index scores. Resistance to thyroid hormones was greatly improved by LSG. The decrease in UA levels after surgery is correlated with the improvement of thyroid hormone resistance after LSG.

The Ethanol Extract Fractionation (Peperomia Pellucida (L.) Kunth) On Uric Acid Levels Blood Serum Of Male White Mice

Research has been carried out on the effect of fractionating the ethanol extract of the messenger herbs (Peperomia pellucida (L.) Kunth) to reduce blood serum uric acid levels in male white mice. Ordered herbs containing flavonoid compounds are thought to be used as lowering uric acid levels in the blood. The purpose of this study was to determine the effect of giving the ethanol extract fraction (Peperomia pellucida (L.) Kunth) on blood serum uric acid levels of male white mice. Simplicia extraction was carried out with 96% ethanol and extract fractionation was carried out using n-hexane, ethyl acetate, and water as solvents. The chicken liver inductor was used using experimental methods in vivo. Uric acid levels in mice were measured using a test-strip out. The results of the analysis using statistical tests on the decrease in uric acid levels in the blood were significant with a value (p 0.05) on the 14th day of the ethyl acetate fraction. This study concludes that there are compounds in the messenger herbs that have the potential to reduce uric acid levels in the blood.

The Effect of Celery Juice and Boiled Water on Reducing Uric Acid Levels in The Elderly of Tanjung Alam

Background: Uric acid is the end result of the metabolism of purines in the form of nucleoproteins, which are one component of nucleic acids found in the nuclei of body cells. Celery boiled water containing apiin and apigenin is believed to reduce uric acid levels naturally without causing side effects. This study aims to examine the effect of celery boiled water on reducing uric acid levels in the elderly. Purpose of the study: The purpose of this study was to identify the effect of giving celery boiled water on reducing uric acid levels in the elderly in Tanjung Alam Village. Methods: The study used pre-experiments with One Group Pretest Posttes design. Sampling technique with simple random sampling technique. The number of samples was 66 elderly people. Results: The results of statistical analysis using the Paired T-Test test. The results of the Paired T-test test on 66 elderly people showed a decrease in uric acid levels with a p-value of 0.000 (p &lt;0.05). This shows that there is an effect of celery boiled water on reducing uric acid levels in the elderly. Conclusion: Based on the results of the study, there is an effect of giving celery boiled water on reducing uric acid levels in the elderly. Giving this therapy can be used to reduce uric acid levels in the elderly by doing it regularly with 200 cc every morning.

Description Of Increased Uric Acid Levels In Ujung Tanduk Village Communities Before And After Drinking Tuak

Tuak is a type of alcoholic drink made from palm sugar. Continuous excessive consumption of palm wine can increase uric acid levels in the body. Uric acid is part of purine metabolism, but if metabolism occurs abnormally there will be a process of accumulation of uric acid crystals in the joints which causes quite high levels of pain such as joint disorders (Gouty arthritis). The aim is to determine the description of uric acid levels before and after consuming palm wine in residents in Ujung Tanduk Village, Laguboti District. The research that will be used is a quantitative type of research with a descriptive research design, with a purposive sampling technique. The results showed that 8 research samples, 2 people (25%) of the sample consuming 4 glasses of palm wine experienced a decrease in uric acid levels with an average of 0.25 mg/dl, 4 people (50%) of the sample consuming 6 glasses of palm wine experienced an increase in uric acid levels with an average of 0.4 mg/dl, and 2 people (25%) of the sample who consumed 8 glasses of palm wine experienced an increase in uric acid levels with an average of 1.25 mg/dl. Consuming too much palm wine can increase uric acid, therefore reducing the frequency of consuming palm wine can reduce uric acid levels.

#5814 SGLT2 INHIBITORS IN IGA NEPHROPATHY: REAL-WORLD CLINICAL PRACTICE

Abstract Background and Aims Immunoglobulin A nephropathy (IgAn) is a common type glomerulonephritis that often progresses to advanced CKD despite the use of ACEi/ARBs and immunosuppression. DAPA CKD has demonstrated that dapagliflozin reduced the risk of CKD progression in patients with IgAn at high risk of progression (mean eGFR, 43.8 mL/min/1.73 m2, and median urinary albumin-to-creatinine ratio, 900 mg/g) for a median follow up of 2.1 years. EMPA KIDNEY demonstrated that empagliflozin was associated to a lower risk of progression of CKD than placebo in a pool of 853 patients with glomerular diseases also at higher risk of progression at 2 years of follow up. Based on both RCT, SGLT2i have been proposed as new therapeutic tools for management of IgAn. However, there is a lack of studies in real-world clinical practice. Thus, we aimed to evaluate the renal effect of SGTL2i at 12 months in a cohort of patients with biopsy proven IgAn. Method Multicenter retrospective observational study including all patients with biopsy proven IgAn who received SGLT2i in 2 hospitals in Spain. Results 19 patients were included, followed up for 12 months. 73,7% were men with a mean age of 48,37±16,74 and a mean evolution of IgAn of 3,5 years before SGLT2i initiation. 21% presented type 2 DM. Oxford scores were: M0 68,42%, M1 26,31%; E0 78,95%, E1 5,79%; S0 68,42%, S1 26,31%; T0 84,21%, T15,26%, T2 5,26%. No patient presented with crescents, and 63-42% presented IF and TA. Before SGLT2i, 21% have received immunosuppression, and 2 were on steroids at the time of SGLT2i initiation (one budesonide). 94,7% were on ACEi/ARBs. 57,9% received dapagliflozin, 15,8% empagliflozin and 26,3% canagliflozin. At baseline, patients showed creatinine 1,10 (0,91-1,49) mg/dL, eGFR 69,84±28,446 ml/min/1.73 m2, and UACR 315,00 (210,75-590,75) mg/g. As showed in Table 1, there is a transient decline in eGFR at month 1 after SLGT2i but then, there was a tendency to an improvement in eGFR (from 69,84±28,446 at baseline to 87,83±31,33), and a tendency to a decrease in UACR from 315,00 (210,75-590,75) at baseline to 152,00 (86,75-423,75) at month 12. From month 3 after SGLT2i, a significant decrease in uric acid was observed, and, at month 6, better systolic and diastolic BP control was achieved. A tendency to higher Hb levels was also observed, as well as a decrease in weight at the end of follow up. Interestingly, SGLT2i withdrawal was only necessary in 1 patient who presented acute pyelonephritis and AKI, requiring dialysis (baseline eGFR 20 ml7min.1.73 m2 and previously known episodes of urinary tract infection). No other adverse events were found. Conclusion In a cohort of patients with IgAn at high risk of progression, a stabilization of renal function was found at 12 months after SGLT2i initiation, with no decrease in eGFR and no increase in UACR. Treatment with SGLTi was associated to a decrease in uric acid levels, a better blood pressure control, and to an increase in Hb levels. Thus, in real-world clinical practice, SGLT2i seem to be a promising therapy for modifying the clinical course of IgAn with a favorable safety profile.

#6359 DAPAGLIFLOZIN TREATMENT IN AUTOSOMAL DOMINANT ALPORT SYNDROME (ADAS)

Abstract Background and Aims Alport Syndrome (AS; ORPHA 63) is one of the most frequent hereditary kidney diseases (HKD). Its autosomal dominant form due to COL4A3-4 heterozygous mutations is being increasingly diagnosed thanks to the generalization of genetic studies. Since there is no curative treatment for the disease, management is based on drugs that slow its progression, mainly RAAS inhibitors. The SGLT2 inhibitor Dapagliflozin has demonstrated to slow chronic kidney disease (CKD) progression by decreasing proteinuria, however very few ADAS patients were included in its clinical trial. Our aim is to analyze whether dapagliflozin is associated with a decrease in proteinuria in ADAS patients. Method In this prospective observational study, we analyzed 12 ADAS patients that started dapagliflozin due to proteinuria in spite of maximum tolerated RAAS inhibitor treatment and eGFR &amp;gt; 25 ml/min/1.73 m2. We analyzed diabetes and hypertension presence (and its control), weight changes, possible adverse effects and laboratory variables before and after treatment initiation (Cr, eGFR, K, uric acid, albuminuria, proteinuria). Results During a mean follow-up period of 7±4 months, we observed 12 patients, 5 (41.7%) male, 61±10 years old. 2 (33.3%) had type 4 diabetes, 2 (16.7%) had impaired fasting glucose (IFG), 11 had hypertension diagnosis, 1 patient had obesity (BMI 36) and other 7 were overweight (mean BMI 28±2). 9 patients had the higher dose of an RAASi, the other three couldn’t achieved it because of hypotension events. 3 patients also took an antagonist of mineralocorticoid. Only one had another diuretic prescription (furosemide 40 mg/d). Mean proteinuria prior to Dapagliflozin initiation was 1.0±0.4 gr/d, protein-to-creatinine ratio (UPCR) 1275±635 mg/g and albumin-to-creatinine ratio (ACR) 784±418 mg/g. 10 out of the 12 patients had some grade of decrease in their proteinuria, with a mean decrease of 416±183 mg/g of UPCR (p = 0,046) and a mean decrease of 292±178 mg/g of ACR (p = 0,020). Looking only at patients without diabetes, they had a lesser degree of estimated glucosuria than diabetes patients, but maintained the improvement in proteinuria quite similar to the overall group (mean ACR improvement 244±95 mg/g). All patients had optimal blood pressure control, and there were no significant body weight losses. Mean eGFR previous to SGLT2i initiation was 50±22 ml/min/1.73 m2, and after 45±19 ml/min/1.73 m2 (p = 0,008), with a mean fall of 8±8%. There were no differences in potassium levels (p = 0,079) and a decrease of uric acid levels (6.7±1.3 mg/dl vs 6.0±1.4 mg/dl, p = 0,016). The two patients who didn’t achieve an improvement in their proteinuria were not diabetic patients and had optimal blood pressure control, one of them had a weight gain of two kilograms, and the other had no weight changes. They had a similar eGFR fall to the overall group. Possible adverse events were monitored, although we didn’t find any of them: no urine tract infections, hyperpotassemia, acute kidney injury, dehydration. No patient required treatment suspension. Two of them required a withdrawal in their other diabetes medications and the one on furosemide tried a lesser dose but had to increase it again. Conclusion Slower progression drugs are the main treatment of ADAS nowadays. Dapagliflozin had demonstrated its beneficial effects in other proteinuric CKD, but it hasn’t been well studied in ADAS. In our sample, it seems to achieve a proteinuria improvement without significant adverse effects and known bearable eGFR fall. Large studies must be considered to determine its beneficial use in a long-time basis.

The Effect of Binahong (Anredera cordifolia (Ten.) Steenis) Leaf Ethanolic Extract on the Reduction of Blood Uric Acid Levels in Hyperuricemic Male White Wistar Rats (Rattus norvegicus)

Highlights: Antioxidant flavonoid compounds can be found in binahong leaf extract. Binahong leaf extract is as effective as allupurinol in reducing uric acid levels. Abstract: Binahong (Anredera cordifolia (Ten.) Steenis) is empirically used to treat burns, rheumatism, gout, typhoid, and stroke. Binahong leaves contain flavonoids that have an antioxidant effect. This study aimed to identify and test binahong leaf flavonoid compounds’ antioxidant properties in reducing uric acid levels. This study began by producing binahong leaf extract and then identifying the flavonoid content with a phytochemical test. The results indicated that the binahong leaf extract contained antioxidant flavonoid compounds. The data were followed by testing flavonoid activity in lowering uric acid levels. This study used male white Wistar rats, of which the uric acid was induced by chicken liver juice. The animals used in the test were 25 rats divided into five groups (i.e., negative control group, positive control group, and treatment groups with dose I, dose II, and dose III). In each group, there were five male white rats. This study was a laboratory experiment using a pre-test post-test design with control groups (pre-test post-test control group design), where the grouping was done based on a randomized group design. By using statistical tests, the results obtained showed that there was a significant decrease of uric acid levels in the positive control group and the treatment group. In conclusion, binahong leaf ethanolic extract can reduce blood uric acid levels induced by chicken liver juice in male white Wistar rats.

Uji Efek Penurunan Kadar Asam Urat Ekstrak Daun Kelor (Moringa Oleifera Lamk) pada Tikus Putih Jantan Galur Wistar (Rattus Norvegicus)

Gout is a disease of the residual metabolism of purine substances derived from the rest of the food we consumed. This study used Moringa oleifera Lamk as a treatment for gout. This study aims to know the effect of Moringa oleifera Lamk leaf extract on decreasing uric acid levels in male white rats wistar (Rattus norvegicus). This study used maceration method, using male white rats aged 2-3 months, weighing 100-150 grams. Rats were divided into 10 groups. Each group consisted of 3 rats. Induction given was chicken liver juice as much as 5 ml/200 gBB for 7 days orally.On the 7th day, measurement of uric acid was carried out 6 hours after the last induction. Giving group for negative control was given 1% CMC,for positive control Allopurinol was given, and for giving Moringa leaf extract on fresh and dry leaves dose 2,5 mg/gBB, 4,5 mg/gBB, 9 mg/gBB, 18 mg/gBB every day orally for 7 days. Measurement ofthe decrease in uric acid levels using the Easy Touch® GCU test strip on the 14th day in the 60th, 120th, and 180th minutes. The results showed that freshMoringa(Moringa oleifera Lamk) leaf extract was more effective in reducing uric acid levels in male whitewistar rats (Rattus norvegicus) and dosage which affects the decreasion of uric acid levels in male white rats wistar strain (Rattus norvegicus) is a dose of 18 mg/gBB in the 120th minutes.

PENDIDIKAN KESEHATAN UNTUK MENGONTROL KADAR ASAM URAT PADA PENDERITA GOUT ARTHRITIS

Gout arthritis is a metabolic disorder that attacks the joints, causing inflammation and pain. A person in this condition can experience limitations in activities, even affecting their mental state because they cannot carry out their role, thus impacting the quality of life of sufferers of gout arthritis. Health education about efforts to control uric acid levels so that gout arthritis does not occur or experience a relapse can increase people's knowledge and attitudes so that changes in good behavior can occur. This health education activity aims to increase the knowledge and attitudes of the people in Likupang Dua Village so that they can adopt a healthy diet pattern. This activity involved 53 gouts of people with arthritis. The method used was examining uric acid levels, lectures, and discussions, then respondents were asked to adopt a healthy diet for one week, then re-examined uric acid levels. The media are uric acid level measuring instruments, LCDs, laptops, power points, and leaflets. The results of this health education activity showed that 81% of respondents experienced a decrease in uric acid levels after being given health education and following dietary recommendations for one week. This health education needs to be reminded frequently to the public and continue to motivate them to continuously live a healthy life so that there is no recurrence in people with gout arthritis.

HUBUNGAN ANTARA PENDAMPINGAN KELUARGA DENGAN PENURUNAN KADAR ASAM URAT PENDERITA GOUT ARTHRITIS PADA LANSIA

The prevalence of gout in Indonesia is increasing, especially in the elderly, then there is a need for family assistance to help the healing process of the disease experienced by the elderly. This study was cross sectional design. The number of samples in this study were 38 respondents with a total sampling technique. The independent variable was family assistance, the dependent variable was the decrease in uric acid levels in patients with gout arthritis in the elderly. The instrument was a questionnaire and observation sheets. The analysis used spearman rank. The results of statistical tests by using the Spearman rank test obtained a sig value (p = 0.002) with a 95% confidence level (ɑ = 0.05) thus it can be said that p = 0.002 &lt; 0.05, then H0 was rejected and H1 was accepted. Thus, it can be concluded that there was a correlations between family assistance and decreased uric acid levels in patients with gout arthritis in the elderly at Desa Rejosari in Kecamatan Mantewe, Tanah Bumbu in 2022. From the results of this study, it was expected that families can provide support and motivation to prevent uric acid levels suffered by elderly.

Antihyperuricemia Activity Of Kupa (Syzygium polycephalum) Seed Extracts In Male White Mice

Hyperuricemia is a clinical condition of increasing uric acid in the blood beyond normal. Increasedlevels of uric acid can accumulate monosodium urate crystals. Kupa fruit seeds contain flavonoids,saponins, tannins, and polyphenols which have antihyperuricemia activity. This study aims todetermine the best antihyperuricemia activity of several kupa seed extracts. The study was conductedin vivo using male white mice. Negative, positive, n-hexane extract, ethanol extract, and ethyl acetateextract were induced by acetylsalicylic acid 5.04 mg/20gBW of mice and fructose 67.2 mg/20gBWof mice orally for 3 days. On the 3rd day of treatment, the positive group was given allopurinol 0.997mg/20gBW and the 3 test groups were each given a different extract of 1.82 mg/20gBW mice orallyfor 7 days. The results showed the ethanol extract of Kupa fruit seeds had the best antihyperuricemiaactivity with a decrease in uric acid levels of 68.29%. Based on the results, the group of mice treatedwith ethanol extract had significantly different activity from the negative control group p &lt;α (0.015&lt;0.05). The ethanol extract showed the best antihyperuricemia activity approaching allopurinol as apositive control.