Uric Acid Levels Research Articles

Comparative multi-omics analyses uncover the distinct quality characteristics of different fish soup varieties

Fish soup has become an integral part of global cuisine, appreciated for its rich nutritional benefits and delectable flavor. This study comparatively evaluated the quality characteristics of fish soups derived from three freshwater fish species and three seawater fish species using multi-omics analysis. The primary aroma characteristics of fish soup were meaty and greasy, closely associated with the oxidation of lipids, particularly unsaturated triglycerides. Compared to freshwater fish soup, seawater fish soup exhibited a higher degree of lipid unsaturation, with significantly elevated levels of highly unsaturated lipids. Umami, the predominant taste profile of fish soup, likely resulted from the synergistic umami-enhancing effect of amino acids (Glu and Asp) and 5′-nucleotides (IMP, AMP, and GMP). The high taurine content in fish soup makes it an excellent dietary supplement. Notably, the 5′-nucleotide content in fish soup is substantial and should be consumed in moderation by individuals with elevated uric acid levels.

Carbon dots modified hydrange-shaped ZnCo(OH)F used as a flexible electrode for sensitive detection of dopamine and uric acid

Dopamine (DA), widely recognized as the most prevalent catecholamine neurotransmitter in the brain, functions as a vital regulator of various physiological processes within the central nervous system. Meanwhile, uric acid (UA) serves as the terminal product of purine metabolism, and hyperuricemia emerges as a significant risk factor for gout, with a steep escalation in risk as blood uric acid levels surge. Consequently, monitoring the concentrations of DA and UA in biological fluids is crucial not only for the treatment of related disorders but also for enhancing disease prevention strategies. In this work, the blooming hydrangea shaped ZnCo(OH)F/carbon dots (CDs) composite was grown on carbon cloth (CC) substrate by a simple hydrothermal method, which was used as a flexible sensor for the detection of DA and UA. The unique open structure and morphologic adjustment strategy of ZnCo(OH)F/CDs/CC provided a large surface area and highly exposed active site. After screening the experimental variables that affect the sensor performance, the optimal ZnCo(OH)F/CDs/CC flexible electrode achieved individual and simultaneous detection for DA and UA in the concentration ranges of 1.0220.0µM and 1.0500.0µM, the detection limits (LOD) of DA and UA were 0.0129 and 0.044μM, respectively (S/N=3). In addition, the sensor exhibited good repeatability, stability and selectivity, realizing the detection of DA and UA in human serum with recovery rate of 95.20% 105.3%. Also, the density functional theory (DFT) calculations were used to explore the interaction between electrode material and detected substrate. A simple hydrothermal method was utilized to grow the ZnCo(OH)F/CDs composite onto the CC substrate. The presence of F− in ZnCo(OH)F can increase the charge mobility and improve the conductivity. ZnCo(OH)F/CDs/CC as flexible electrode material can determine DA and UA simultaneously in human serum with a satisfactory recovery rate. This flexible sensor has a broad application prospect in the manufacture of wearable devices.

Effects of ertugliflozin on uric acid and gout-related outcomes in persons with type 2 diabetes and cardiovascular disease: Post hoc analyses from VERTIS CV.

To conduct post hoc analyses of the VERTIS CV (NCT01986881) trial to explore the effects of ertugliflozin on serum uric acid (UA) and gout-related outcomes. Participants with type 2 diabetes and atherosclerotic cardiovascular disease were randomised (1:1:1) to placebo, ertugliflozin 5 mg or ertugliflozin 15 mg. Mean UA over time (260 weeks) was evaluated for pooled ertugliflozin versus placebo overall, and by baseline quintile of UA (≤4.3 mg/dL [≤255.8 µmol/L], >4.3-5.1 mg/dL [>255.8-303.4 µmol/L], >5.1-5.8 mg/dL [>303.4-345.0 µmol/L], >5.8-6.9 mg/dL [>345.0-410.4 µmol/L] and >6.9 mg/dL [>410.4 µmol/L]), glycated haemoglobin level, albuminuria status, estimated glomerular filtration rate and KDIGO (Kidney Disease: Improving Global Outcomes in Chronic Kidney Disease) risk category. The effect of ertugliflozin on a composite of gout onset or initiation of anti-gout medication was assessed. The mean UA levels at baseline were 5.67 and 5.62 mg/dL in the placebo and ertugliflozin groups, respectively. Ertugliflozin reduced UA over Weeks 6-260 compared with placebo, with least squares mean (LSM) changes (95% confidence interval [CI]) from baseline at Week 260 of 0.07 mg/dL (-0.02, 0.15) and -0.19 mg/dL (-0.25, -0.13) in the placebo and pooled ertugliflozin groups, respectively. At Week 260, placebo-adjusted LSM change (95% CI) from baseline in UA was -0.26 mg/dL (-0.36, -0.16) with ertugliflozin. Ertugliflozin was associated with reductions in UA across baseline UA quintiles compared with placebo. The incidence of the composite of gout-related outcomes was 84/2539 (3.3%) for placebo and 133/5091 (2.6%) for ertugliflozin (hazard ratio for the composite 0.76 [95% CI 0.580, 1.002]). Ertugliflozin was generally associated with lowering UA overall and across subgroups compared with placebo, and numerically reduced rates of gout-related outcome events.

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.

Diet as a treatment for chronic kidney disease

The management of chronic kidney disease (CKD) includes nutritional interventions aimed at slowing disease progression and mitigating complications. This review examines various dietary approaches for CKD treatment, focusing on carbohydrate intake modulation, ketogenic diets, and plant-based diets. Standard guidelines recommend carbohydrate intake within 45% to 65% of total calories, but there is growing interest in reducing carbohydrate consumption to preserve kidney function. Low-carbohydrate diets (<25% of total calories) have shown benefits in glycemic control and weight reduction but may pose long-term adherence challenges. High-protein, low-carbohydrate diets are discouraged due to associations with hyperfiltration and CKD progression. Limiting fructose intake has been linked to reductions in blood pressure and uric acid levels. Intermittent fasting and ketogenic diets, which promote ketone body production and reduce inflammation, have shown promise in animal models and some human studies, particularly in autosomal dominant polycystic kidney disease, though more research is needed. Plantbased diets, such as the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, offer cardiovascular benefits and may reduce CKD risk but require careful management of potassium intake. Overall, dietary interventions should be individualized, considering potential risks like hyperkalemia and ensuring nutritional adequacy.

Hyperuricemia and epiretinal pathologies: a review of pathophysiological links and clinical implications

Hyperuricemia (HUA), defined by elevated serum uric acid levels, is well-established in its association with systemic conditions like gout and cardiovascular diseases. Recently, however, emerging research has revealed a potential connection between HUA and ocular disorders, particularly epiretinal pathologies. This review investigates the pathophysiological mechanisms linking HUA to epiretinal conditions, including epiretinal membrane formation, macular edema, and retinal vascular diseases. By thoroughly analyzing current literature, this review seeks to deepen the understanding of the relationship between HUA and epiretinal disorders, with the aim of informing new therapeutic strategies and enhancing patient outcomes.

Effects of substituting soybean meal with fermented rapeseed meal mixture on the growth performance, slaughter performance, meat quality, blood biochemical indices and intestinal barrier function in Langshan Chickens

This study aimed to explore the effects of substituting soybean meal with a mixture of solid-state fermented rapeseed meal, apple pomace, and wheat bran on the growth performance, slaughter performance, meat quality, blood biochemical indices and intestinal barrier function of Langshan chickens. A total of 144 30-day-old Langshan chickens with similar body weights were randomly divided into three treatment groups, with six replicates per group and eight chickens per replicate: the control group (CON) was fed a corn-soybean meal basal diet, while the rapeseed meal mixture group (RSM) and the fermented rapeseed meal mixture group (FRSM) were fed diets substituting 5 % of soybean meal with rapeseed meal mixture and fermented rapeseed meal mixture, respectively. The trial lasted from 30 to 58 days of age. The results showed that compared to the CON group, the RSM group exhibited no significant changes in average daily feed intake (ADFI), average daily gain (ADG) and feed to gain ratio (F/G) (P > 0.05); the dressing percentage, half-eviscerated yield and eviscerated yield decreased (P < 0.05); the pH24h and yellowness of breast muscle increased (P < 0.05); the crypt depth of the jejunum decreased, and the villus height/crypt depth ratio increased (P < 0.05); the serum D-lactic acid content decreased (P < 0.05). Compared to the CON group, the FRSM group exhibited no significant changes in ADFI, ADG and F/G (P > 0.05); the eviscerated yield increased (P < 0.05); the serum glucose and uric acid levels decreased (P < 0.05); the crypt depth of the jejunum decreased, and the villus height/crypt depth ratio increased (P < 0.05); the serum D-lactic acid content decreased (P < 0.05). Furthermore, compared to the RSM group, the FRSM group exhibited no significant changes in ADFI, ADG and F/G (P > 0.05); the dressing percentage, half-eviscerated yield and eviscerated yield increased (P < 0.05); the pH24h of breast muscle decreased; the serum glucose and uric acid levels decreased (P < 0.05).In conclusion, RSM reduced the slaughter performance of Langshan chickens, while FRSM improved their slaughter performance. Both RSM and FRSM improved the jejunal morphology and intestinal permeability in Langshan chickens. In conclusion, fermentation improved the feed value of the rapeseed meal mixture; replacing part of the soybean meal diet with fermented rapeseed meal mixture helped improve the slaughter performance and intestinal barrier of Langshan chickens.

Green tea (Camellia sinensis L.) potential to liver of hyperuricemia rats (Rattus norvegicus) fed with high purine diet

Uric acid is produced in tissues containing xanthine oxidases, like the small intestine and liver, as involved in the purine metabolism of adenine and guanine. High uric acid levels cause damage to cell membranes due to the lipid peroxidase chain reaction. Foods containing high purines will activate the xanthine oxidase (XOD), causing an increase in free radicals. Free radicals attack polyunsaturated fatty acids (PUFA) by forming lipid peroxides. PUFA molecules contain multiple double bonds, which make them susceptible to oxidation by reactive oxygen species (ROS), such as free radicals. PUFA will be broken into simple compounds such as pentane, ethane, and aldehydes, leading to malondialdehyde (MDA) formation. High MDA levels illustrate the process of cell membrane oxidation leading to cell membrane damage. Hyperuricemia is often treated using synthetic drugs such as allopurinol; however, it can cause side effects. Some people will choose medicinal plants with minimal side effects. Green tea (Camellia sinensis L.) contains many polyphenol antioxidants, especially flavonoids, which also have a strong antioxidant effect by exerting multiple mechanisms such as inhibiting several enzymes, including antiphospholipid peroxidase, free radical scavengers, metal bonds, and xanthine oxidase (XOD). Statistical analysis results proved that green tea with a dose of 600 mg/kg BW could decrease the level of MDA in the liver by 84.87% (p 0.01) and reduce the activity of XOD by 35.36% (p 0.01). Taken together, green tea can improve liver histopathology.

Hyperuricemia suppresses lumican, exacerbating adverse remodeling after myocardial infarction by promoting fibroblast phenotype transition

BackgroundHyperuricemia is independently associated with a poor prognosis in patients with myocardial infarction (MI). Furthermore, MI induces activation of the repair response in local fibroblasts, resulting in extracellular matrix accumulation that generates a stable fibrotic scar in the infarcted area. However, researchers have not determined whether hyperuricemia affects fibroblast activation and its involvement in postinfarction cardiac remodeling.ObjectivesWe aimed to trigger hyperuricemia by administering potassium oxonate in a mouse model of MI to evaluate the role of hyperuricemia in MI pathogenesis.MethodsMicroarray datasets and single-cell sequencing data from gout patients, heart failure patients, and model mice were used to identify the underlying mechanisms responsible for the effect of hyperuricemia on MI progression. A hyperuricemia-related MI mouse model was established. Cardiac function was assessed, followed by sample collection and a uric acid assay. We conducted an enzyme-linked immunosorbent assay, histological detection, immunofluorescence, sequencing data processing, single-cell RNA-seq, and functional enrichment analysis. We then isolated and cultured cardiac fibroblasts and performed Western blotting, quantitative real-time polymerase chain reaction, and shRNA-mediated lumican knockdown assays.ResultsHyperuricemia decreased cardiac function, increased mortality, and aggravated adverse fibrosis remodeling in mice after MI. These outcomes were closely related to reduced levels of fibroblast-derived lumican. This reduction activated the TGF-β/SMAD signaling pathway to induce aberrant myofibroblast activation and extracellular matrix deposition in the infarcted area. Furthermore, lumican supplementation or uric acid-lowering therapy with allopurinol alleviated hyperuricemia-mediated abnormal cardiac remodeling.ConclusionHyperuricemia aggravates postinfarction cardiac remodeling by reducing lumican expression and promoting fibroblast phenotype transition. We highlight the clinical importance of lowering uric acid levels in hyperuricemia-related MI to prevent adverse ventricular remodeling.

Impact of Hyperuricemia on Clinical Outcomes in Sepsis Patients: A Retrospective Cohort Study.

Background: Hyperuricemia has been linked to various adverse clinical outcomes. Data on the clinical outcomes and the relationship between hyperuricemia and sepsis remain limited. The aim of this study was to evaluate the impact of hyperuricemia on clinical outcomes in sepsis patients and to identify whether it can predict the mortality in this patient population. Methods: This was a retrospective cohort study of adult patients with sepsis admitted to the intensive care unit (ICU) from 1 January 2021 to 31 December 2023. The patients were divided into hyperuricemia and non-hyperuricemia groups. Hyperuricemia was defined as a serum uric acid level > 416.4 µmol/L (7.0 mg/dL) in males or >357.0 µmol/L (6.0 mg/dL) in females based on the first serum uric acid reading within 24 h of ICU admission. The primary outcome of this study was ICU mortality. Secondary outcomes included in-hospital mortality, progression to septic shock, and ICU and hospital lengths of stay (LOSs). Results: A total of 599 patients were included in the study. Among these, 303 were in hyperuricemia group, while 296 were in the non-hyperuricemia group. The incidence of ICU and in-hospital mortality was higher in the hyperuricemia group compared to the non-hyperuricemia group (26.7% vs. 18.9% (p < 0.001) and 34.7% vs. 19.3% (p < 0.001), respectively). After adjusting for cofounders, hyperuricemia was not a predictor of ICU mortality (OR 1.52, 95% CI 0.95-2.43, p = 0.083). Most secondary outcomes were similar between the groups. However, the hyperuricemia group had a higher incidence of progression to septic shock (67.3% vs. 50.7%, p < 0.001), and hospital LOS was significantly longer in the hyperuricemia group (384 vs. 264 h, p = 0.004). Conclusions: Our findings demonstrated that hyperuricemia in sepsis patients was associated with worse clinical outcomes such as higher ICU and hospital mortality. Moreover, there was a higher incidence of septic shock progression and longer hospital LOS. The other outcomes were not statistically significantly different. Further prospective research is warranted to confirm these findings.

Investigating the causal association between serum uric acid levels and gastric cancer risk: a Mendelian randomization study

The causal link between serum uric acid (SUA) levels and gastric cancer susceptibility remains inadequately elucidated. This investigation employed a two-sample Mendelian randomization (MR) framework to assess the potential causative link between SUA concentrations and the propensity for developing gastric cancer. To further explore potential racial differences, this MR analysis was conducted on cohorts of both European and East Asian descent. Data from a large-scale GWAS in 343,836 Europeans and 92,615 East Asians were screened for 206 and 45 SNPs significantly linked to SUA levels, respectively, as genetic variants. Subsequently, four distinct MR methodologies were deployed to determine how SUA levels affected gastric cancer risk. Using the fixed-effects IVW approach, our analysis revealed no significant association between SUA levels and gastric cancer risk, with P-values exceeding the threshold of significance in both populations (European P = 0.778; East Asian P = 0.245). The findings were supported by three additional MR methods. The reliability of these results was substantiated by comprehensive sensitivity analyses. In summary, our data do not support a significant causal linkage between SUA levels and gastric cancer risk.

Clinical characteristics and prognosis analysis of acute symptomatic seizures secondary to autoimmune encephalitis.

This study aimed to analyze the clinical characteristics and prognosis of patients with autoimmune encephalitis (PWAE) who experienced seizures during the acute phase. Clinical data were collected from 84 patients diagnosed with AE at the General Hospital of Ningxia Medical University between January 2015 and January 2023. Patients were divided into seizure and non-seizure groups. Clinical characteristics of both groups were compared, including differences between anti-NMDAR and anti-LGI1 encephalitis within the seizure group. Due to the limited sample size and to avoid overfitting, we focused on univariate logistic regression analysis to identify individual prognostic factors. A total of 84 patients were enrolled, with 76.19% (64/84) in the seizure group and 23.81% (20/84) in the non-seizure group. The seizure group had a longer hospital stay (p = 0.013), higher rates of impaired consciousness (p = 0.001), and more frequent intensive care unit (ICU) admission (p = 0.011). They also had higher peripheral blood neutrophil-to-lymphocyte ratio (NLR), leukocyte count, and uric acid levels (p = 0.038, p = 0.006, p = 0.020), and were more likely to show slow-wave rhythms on electroencephalography (EEG) (p = 0.031). At 2-year follow-up, there was no significant difference in prognosis between the seizure and non-seizure groups (p = 0.653), with 35.94% (23/64) of the seizure group having a poor prognosis. Status epilepticus (SE), complications, endotracheal intubation, mRS score at discharge, APE2, and RITE2 scores increased the risk of poor prognosis (OR > 1), while intensive care and albumin reduced the risk (OR < 1). Seizures are common in the early stages of AE, with faciobrachial dystonic seizures (FBDS) characteristic of anti-LGI1 encephalitis and SE and super-refractory status epilepticus (Sup-RSE) frequently observed in anti-NMDAR encephalitis. Seizure semiology across AE subtypes lacks specificity, and no symptoms clearly distinguish immune-mediated from non-immune causes. While seizures are linked to AE severity, particularly in anti-NMDAR encephalitis, they do not appear to impact overall prognosis. SE, complications, endotracheal intubation, modified Rankin Scale (mRS) score at discharge, Antibody-Prevalence in Epilepsy and Encephalopathy (APE2) score, Response to Immunotherapy in Epilepsy and Encephalopathy (RITE2) score, intensive care, and albumin were identified as significant prognostic factors.

Serum autotaxin positively associates with hypertension in postmenopausal women: a single center study in China.

Autotaxin is an adipokine involved in metabolic disorders. The aim of the current study was to evaluate serum autotaxin levels in hypertensive postmenopausal women and establish a relationship between autotaxin and other comorbidities in this special group. This single-center study included postmenopausal women who received annual health examinations at the First Affiliated Hospital, College of Medicine, Zhejiang University in Zhejiang, China. The metabolic and demographic characteristics of the subjects, including age, sex, height, weight, blood pressure, and biochemical indices, were collected. The serum autotaxin level was measured via ELISA. The Kolmogorov-Smirnov test, Student's t test, Mann-Whitney U test, χ2 test, receiver operating characteristic (ROC) curve analysis, Spearman correlation analysis and multivariate logistic regression analysis were adopted for statistical analysis. This pilot observational study included 25 hypertensive postmenopausal women and 25 age-matched normotensive controls. Hypertensive patients presented significant metabolic disturbances with greater comorbidities such as nonalcoholic fatty liver disease, obesity, overweight, diabetes, hypertriglyceridemia and hyperuricemia (P < 0.05), impaired renal health with higher uric acid levels (P < 0.001), and slightly elevated creatinine levels (P = 0.156) with lower estimated glomerular filtration rates (eGFRs) (P = 0.195). The serum autotaxin level was markedly greater in the hypertensive group (239.0±59.6 ng/ml vs. 192.7 ± 49.0 ng/ml; P < 0.01) and was positively associated with systolic blood pressure; diastolic blood pressure; and alanine transaminase, triglycerides (TG), creatinine, and uric acid levels and inversely associated with the eGFR (P < 0.05) among postmenopausal women. Serum autotaxin levels positively predicted hypertension, with an AU-ROC of 0.750 [95% confidence interval (CI): 0.613-0.888] and a Youden index of 0.480 at a cutoff of 225 ng/ml. In the multivariate logistic regression analysis, after adjustment for demographic and metabolic parameters (including age, BMI, ALT, TB, uric acid, FBG, TG, LDL and creatinine), autotaxin (ATX) remained independently positively correlated with the risk of hypertension [odds ratio: 1.016, 95% CI 1.001-1.031; P < 0.05). Among postmenopausal women, the serum autotaxin level is significantly elevated in the hypertensive group compared with age-matched normotensive controls. ATX is related to multiple metabolic disorders and renal health, suggesting that autotaxin has potential as a multiorgan therapeutic target for cardiovascular-metabolic-renal disorders.

Predicting the risk of chronic kidney disease based on uric acid concentration in stones using biosensors integrated with a deep learning-based ANN system

Elevated levels of uric acid (UA) in the body may not only lead to the formation of stones but also increase the risk of developing chronic kidney disease (CKD). This study presents a biosensor for detecting UA concentration in stones and a deep learning-based artificial neural network (ANN) system for analyzing CKD risk. The biosensor is a screen-printed electrode (SPE) chip, whose surface was modified using oxygen plasma, enabling the detection of UA concentration via cyclic voltammetry. Experimental results show a good linear relationship between UA concentration and anodic peak current within the range of 0.15–5 mM. The surface modification method for this biosensor is simple and cost-effective. The ANN system took age and creatinine values as inputs, utilizing the Chronic_Kidney_Disease dataset and supplementary data from literatures for training. After detecting the UA concentration in stones using the biosensor, the result was converted into serum uric acid concentration, allowing the estimation of creatinine level, which was then used by the ANN to assess the risk of developing CKD. This system can assist urologists in determining whether patients should seek consultation with nephrologists for early diagnosis and treatment.

Gout diagnoses uncertain when made by general practitioners without serum uric acid testing: an observational study.

General practitioners (GPs) diagnose the majority of all gout patients. They make their diagnosis clinically. Serum uric acid (SUA) level >0.35mmol/l is largely determinative for the clinical diagnosis of gout. We aimed to assess to what extent GPs test SUA when making a first gout diagnosis, and to consider consequences regarding diagnostic certainty of not testing it. We calculated proportions of patients from 87 Dutch general practices (1-1-2013 to 1-1-2022) with a first gout diagnosis and a recorded SUA test, evaluated if SUA testing was punctually timed with respect to the diagnosis date, whether SUA levels were >0.35mmol/L, and whether diagnoses corresponded with diagnoses according to the 'Acute Gout Diagnosis Rule' (AGD-rule). In 43.0% of 7782 patients (mean age 64.4 years; 68.8% male) no SUA test result was recorded, with substantial variation among practices: median 41.9% (IQR 20.2%). 'Gout very likely' according to the AGD-rule was seen in all males and in 83.1% of females when a punctually timed SUA >0.35mmol/L was present. When such SUA level was lacking, 'Questionable or indeterminate gout diagnosis' was seen in all males and in 67.1% of females, and 'Arthritis diagnosis other than gout' in 32.9% of females. GPs diagnosed gout without testing SUA in ~40% of cases. This implies avoidable diagnostic uncertainty with impact for the clinical care of many patients as well as for studies that include primary care patients with gout. Key Points • Serum uric acid (SUA) level > 0.35mmol is determinative when diagnosing gout: however, it is unknown how often SUA testing is applied as such. • More than 40% of patients with a first gout diagnosis according to general practitioners (GPs) had no SUA test result registered in their medical record. • Gout diagnosing by GPs without SUA testing appeared to lead to avoidable diagnostic uncertainty, as diagnoses are often questionable or sometimes even wrong. • Researchers investigating gout need to take into account diagnostic uncertainty if they include gout patients who are diagnosed in primary care in their studies without SUA information.

Mildly decreased egfr modifies the association between uric acid and risk of kidney function decline: a 5-year population-based cohort study

Abstract Background the role of uric acid (UA) in chronic kidney disease (CKD) remains controversial. In this study, the effects of UA levels on risk of kidney function (KF) decline in patients with normal or mildly decreased KF at baseline were investigated. Methods Data were extracted from the community-based Tongzhou Cohort Study. The cohort of 4246 patients was divided into the normal KF group (estimated glomerular filtration rate [eGFR] ≥ 90 mL/min/1.73 m2) or mildly decreased KF group (60 ≤ eGFR &amp;lt; 90 mL/min/1.73 m2). The primary endpoint was the risk of kidney function decline, which defined as a composite of a ≥ 30% decrease in eGFR from baseline or new onset of CKD diagnosed during the annual checkups. Results A total of 284 participants reached the primary endpoint during the 5-year follow-up period. There was a significant interaction between UA levels and baseline eGFR (p &amp;lt; 0.001). Restricted cubic spline analysis revealed a U-shaped association between baseline UA levels and the risk of decreased KF for participants with normal KF (cut-off value = 5.0 mg/dL; pnonlinear = 0.025) and a linear association for participants with mildly decreased KF (pnonlinear = 0.384). The odds ratio of an increase in UA levels by 1 mg/dL was 1.15 [95% confidence interval (CI) 1.02–1.31, p = 0.028] for the primary endpoint and 1.15 (95% CI = 1.01–1.31, p = 0.037) for new onset of CKD for participants with mildly decreased KF. Conclusion The association between uric acid and risk of KF decline was U-shaped in participants with normal KF while linear in participants with mildly decreased KF.

CKD incidence, predictors &amp; progression: African migrants vs. Non-Migrants (RODAM cohort study)

Abstract Background Limited longitudinal data exist on chronic kidney disease (CKD) in African populations undergoing epidemiological transitions. We investigated incidence, long-term predictors, and progression of CKD among Ghanaians residing in rural- and urban-Ghana, and Ghanaian migrants in the Netherlands (Amsterdam). Methods We analysed data from 2183 participants in the transcontinental population-based prospective RODAM-cohort, followed for approximately seven years. CKD incidence and its progression to end-stage renal disease (ESRD) were defined using KDIGO criteria. CKD incidence was calculated using age-and sex-standardization for those without CKD at baseline. Long-term predictors of CKD incidence were identified using one-step robust Poisson regression. CKD progression to ESRD from baseline was also assessed using robust Poisson regressions. Results Overall age-and-sex standardized CKD incidence was 11.0% (95%CI; 9.3%-12.3%). Rural and urban-Ghanaians had higher CKD incidence (12.5%;8.5%-15.5%; 12.3%;8.2%-15.8%; respectively) than Amsterdam-Ghanaians (7.6%; 5.4%-10.6%). Residence in Amsterdam was associated with lower CKD incidence compared to rural Ghana after adjustments (Incidence Rate Ratio=0.34; 0.13-0.89), but not with urban-Ghana (IRR=1.07; 0.69-1.67). CKD incidence predictors were advanced age, female sex, alcohol consumption, uric acid levels, and hypertension. CKD progression to ESRD was 2.5% (1.4%-3.6%) in rural- Ghana, 2.3% (1.3%-3.2%) in urban-Ghana and 0.0% in Amsterdam. Conclusions One-tenth of Ghanaians developed CKD over seven-years, with higher incidence in Ghana compared to Europe. Age, female sex, alcohol use, uric acid levels, and hypertension were predictive factors. CKD progression to ESRD was minimal. High CKD incidence among Ghanaians, especially among non-migrants, calls for in-depth assessment of contributing factors and targeted interventions. Key messages • We observed higher CKD Rates in Rural/Urban Ghana vs. Amsterdam:Indicating geographic Disparities. • CKD Predictors: Age, Sex, Alcohol, Uric Acid, Hypertension (Minimal ESRD Progression). Interventions target: Non-Migrant Ghanaians.

The importance of taste salt sensitivity in the development of kidney damage in patients with high-risked arterial hypertension

Abstract Purpose of the study to evaluate the diagnostic significance of determining taste salt sensitivity in kidney damage development in patients with high-risked arterial hypertension. Material and methods The study included 1021 patients with arterial hypertension (AH), 60% women, 40% men, aged 58.05±7.95 years. All patients underwent the R.Henkin test to determine the threshold of taste sensitivity to table salt in the family polyclinics of Aral Sea region. All patients underwent a complete blood count, a complete urinalysis, biochemical tests, determination of serum creatinine with calculation of glomerular filtration rate, microalbuminuria, urine albumin-to-creatinine ratio and uric acid level. Results Low and medium thresholds of taste salt sensitivity were determined in 149 patients (14.6%, group 1), the average NaCl concentration was 0.15±0.02%. A high threshold of taste salt sensitivity was detected in 872 patients (85.4%, group 2), the average NaCl concentration was 0.64±0.57% (p=0.0001). Patients of the 1st and 2nd groups differed in the level of systolic and diastolic blood pressure (SBP and DBP): 150.8±10.0 mmHg. versus 172.0±16.7 mmHg. p=0.0001 for SBP, 91.4±3.8 mmHg versus 100.7±10.13 mmHg, p=0.0001 for DBP in the 1st and 2nd groups respectively. At the same time, there was a noticeable direct correlation between hemodynamic parameters – SBP / DBP and NaCl concentration in the test for determining the taste sensitivity to table salt threshold (r = 0.646; r = 0.610, respectively). As a result, were detected significantly differences in GFR: 97.22±11.42 versus 70.33±16.56 (p=0.0001); MAU: 58.64±35.45 vs. 215.9±126.65 (p=0.0001); albumin to creatinine ratio: 47.88±42.73 vs. 268.46±261.05 (p=0.0001); uric acid: 227.67±43.75 vs. 337.17±86.52 (p=0.0001), for 1st and 2nd groups respectively. Conclusion A high threshold of taste salt sensitivity, determined by the R.Henken method, is associated with the level of SBP, DBP, markers of kidney damage and the level of uric acid, which increases the diagnostic significance of determining taste salt sensitivity in patients with hypertension.

Recent Advances in Amperometric Biosensors for Medical Applications: A Mini-Review.

Amperometric biosensors have emerged as a cutting-edge technology in clinical diagnostics, thanks to their high level of sensitivity, rapid analytical results, compact size, and ability to monitor health parameters non-invasively and continuously using flexible and wearable sensors. This review explores the latest developments in the field of amperometric biosensing for medical applications. It discusses the materials used to construct these sensors and pays particular attention to biosensors designed to measure glucose, lactate, cholesterol, urea, and uric acid levels. The review also addresses the technological limitations and drawbacks of these devices. Furthermore, it presents the current status and identifies future trends in the development of flexible, wearable biosensors capable of providing continuous monitoring of a patient's health status.

The use of allopurinol in prophylaxis against contrast-induced nephropathy in patients undergoing percutaneous coronary intervention

Abstract Background Contrast-induced nephropathy (CIN) is a serious complication after percutaneous coronary intervention (PCI). Inflammation and development of reactive oxygen species are among the postulated mechanisms of CIN. Allopurinol with anti-inflammatory action could be a preventive method of CI-AKI. Aim of the work To determine the effect of adding allopurinol to hydration in the prevention of CIN in patients undergoing PCI, with or without hyperuricemia. Methods One hundred and seven patients with moderate to high Mehran score undergoing elective PCI were randomly allocated to the allopurinol (n=52) or the control group (n=55). Those in the allopurinol group (hyperuricemic n=25, and normouricemic n= 27) received allopurinol 300 mg one day and one hour before PCI beside intravenous hydration (1 ml/kg/hour) normal saline, a maximum of 100 ml/hour for 12 hours pre and post coronary angiography. Patients in the control group (hyperuricemic n=26 and normouricemic n=29), received the same intravenous hydration only. Serum creatinine and urea were measured before and 48 hours after the procedure while the uric acid level was measured before the procedure only. CIN was defined by a percentage increase in serum creatinine of ≥25% or absolute serum creatinine ≥0.5 mg/dl, 48 hours after PCI. Results The mean age of the studied patients was 59.6 ± 9.1 years old, 59% were male. No difference between both groups regarding baseline characteristics or medications. Average Mehran score was 9.0 ± 1.2. CIN was observed in 5 patients in the allopurinol group (9.6%) and 15 patients in the control group (27.3%) (P = 0.017). There was no significant difference between both groups regarding the contrast volume (179.8 ± 68.1 vs. 153.8 ± 57.9 ml, p: 0.052). Hyperuricemia had no significant effect on increasing the incidence of CI-AKI either in patients with or without CKD (p=0.964). Conclusion Allopurinol on the top of hydration was found to decrease the incidence of CIN following PCI in patients with moderate to high Mehran score for CIN. The anti-inflammatory action of allopurinol could be the mechanism of this favorable effect, as baseline uric acid didn't affect the results. Further multi-center study with a larger sample size is needed to offer more definite results.