Mean Serum Uric Acid Level Research Articles

Serum Creatinine and Uric Acid Levels in Hypothyroid Patients: A Cross Sectional Study

Background: Hypothyroidism is associated with many biochemical abnormalities including increased serum creatinine and uric acid levels. Many studies were done abroad regarding serum creatinine and uric acid levels in hypothyroid patients. We designed this study in our population for evaluation of serum creatinine and uric acid levels in hypothyroid patients. Objective: To assess serum creatinine and uric acid levels in hypothyroid patients and to find out relationship of creatinine and uric acid levels with severity of hypothyroidism. Materials and Methods: This retrospective cross sectional study to evaluate the serum creatinine and uric acid levels of hypothyroid patients and to find out relationship of hyperuricemia and hypercreatininemia with severity of hypothyroidism was done in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka. Results were compared with that of age and sex matched healthy euthyroid controls. Statistical analyses were performed by using SPSS for Windows version 10.0. ANOVA and unpaired ‘t’ tests were done to see the significance among the groups and between groups respectively. Pearson’s correlation coefficient test was done to see the correlation of serum creatinine and uric acid levels with the severity of hypothyroidism. Results: Mean serum creatinine and uric acid levels in cases were 1.38 ± 0.53 and 7.00 ± 2.54 mg/dL respectively compared to 1.01 ± 0.17 and 5.21 ± 1.35 mg/dL in controls. Conclusion: Mean serum creatinine and uric acid levels were found significantly higher in hypothyroid patients compared to controls. These findings suggest that hyperuricemia and hypercreatininemia are associated with hypothyroidism. Therefore, patients presenting with these biochemical abnormalities are recommended to be investigated to explore hypothyroidism. Journal of Enam Medical College; Vol 3 No 2 July 2013; Page 84-87 DOI: http://dx.doi.org/10.3329/jemc.v3i2.16129

Association of Serum Uric Acid with Parkinson Disease

Background: Several studies have identified that low serum uric acid (UA) is a possible risk factor for Parkinson Disease (PD). The aim of my study was based on evaluation of association of serum uric acid with Parkinson Disease (PD).
 Objective: To evaluate the association of serum uric acid with Parkinson Disease(PD).
 Methodology: It was a case control study carried out in the Department of Neurology of Bangabandhu Sheikh Mujib Medical University. A total 50 patients of PD aged 45 years or above were taken as cases; and age and sex matched 50 healthy subjects or patients other than PD were taken as control. Serum UA levels were measured in both groups. Besides, any association was searched between serum UA with age, sex, duration and stage of PD, BMI and dietary habit.
 Results: The mean serum uric acid level in case group was 4.25±1.00 mg/dl and that of control group was 4.73±1.29 mg/dl. The mean serum uric acid in case group was statistically significant (p=0.038 which was <0.05) lower than that of control group. Serum UA levels gradually diminished as Hoehn & Yahr stage of PD increased. Also, disease duration of PD was found inversely related with serum UA. Male subjects in both case and control group had higher serum UA level than their female counter-part, but they had statistically significant higher UA in control group. In this study no correlation was found between age and BMI with serum UA in both case and control. Any association between serum UA and dietary habit was not found in this study because maximum subjects of this study used to take average protein diet.
 Conclusion: The aim of the study was to explore the association between serum uric acid with Parkinson Disease. The present study found statistically significant association between low serum uric acid with Parkinson Disease.
 Bangladesh Journal of Neuroscience 2013; Vol. 29 (2) : 115-123

Serum uric acid in relation to serum 1,5-anhydroglucitol levels in patients with and without type 2 diabetes mellitus

ObjectivesThe aim of this study was to examine the relationship between serum levels of uric acid (UA) and 1,5-anhydroglucitol (1,5-AG) in elderly subjects (60years or older; mean age, 73.0±7.2years) with and without type 2 diabetes mellitus (DM). MethodsSubjects with DM (n=97) and without DM (n=360) were recruited from among our outpatients (estimated glomerular filtration rate≥45mL min−1 1.73m−2 , and urine protein equivalent to <1.0g/L), and a cross-sectional study was performed with simple linear regression and stepwise multiple linear regression analyses. ResultsThe mean serum UA levels of men were significantly higher than those of women in both groups. The mean serum 1,5-AG levels of men were significantly higher than those of women in the non-DM group. There were positive correlations (indicated by Pearson's correlation coefficients) between serum UA levels and 1,5-anhydroglucitol levels in all patients and in both men and women. Simple linear regression and multiple linear regression analyses showed that the serum 1,5-AG levels were significantly and positively correlated with the serum UA level in both the non-DM group and the DM group. In the non-DM group, HbA1c levels, as well as 1,5-AG levels, were positively correlated with serum UA levels. Furthermore, the correlation between 1,5-AG and UA levels was stronger in subjects with DM than in subjects without DM. ConclusionsThese results suggest that the serum 1,5-AG level is an independent factor associated with serum UA levels in the nondiabetic state, as in DM.

SAT0347 Cartilaginous Uric Acid Deposition in Advanced Osteoarthritis: Innocent Bystander or Promotor of Cartilage Destruction?

ObjectivesRecent studies have suggested that synovial fluid uric acid could contribute to tissue inflammation, disease severity and progression of osteoarthritis (OA). Intraarticular uric acid has been associated with OA disease...

SAT0539 The Risk of Future Attacks in Patients with Incident Gout: a Population-Based

ObjectivesWhile there appears to be consensus that non-pharmacological uric acid lowering therapies (diet and lifestyle modifications) should be initiated in every patient presenting with gout, there is much less agreement...

The Correlation between Uric Acid Levels and Amyotrophic Lateral Sclerosis

<b>Introduction</b> Uric acid (UA) may act as an antioxidant in ALS pathophysiology. This study examined whether serum UA concentration correlates to clinical course in the ALS patients. <b>Methods</b><b> </b>We measured serum UA levels in 51 sporadic ALS patients, and compared them to 51 age-and-gender-matched healthy subjects. We analyzed the correlation between serum UA levels, illness duration, and disease “course factors” (defined as “disease duration” over “terminal time”) in the ALS patients. <b>Results</b><b> </b>The mean serum UA levels in the ALS groups were higher than the control groups in both genders. Serum UA levels were inversely correlated with the disease “course factors” in the ALS male patients. <b>Discussion</b><b> </b>The elevation of serum UA concentration in ALS patients may be related to oxidative stress. The reasons that serum UA levels inversely correlated with ALS “course factors” include: muscle wasting, poor nutrition, reduced antioxidant reserve, or increased UA consumption in end-stage patients.

Excellent Results of High-Dose Mizoribine Combined With Cyclosporine, Basiliximab, and Corticosteroids in Renal Transplant Recipients—4-Year Results

BackgroundMizoribine (MZR) at 3 mg/kg/d shows less potent immunosuppressive effects, but high-dose MZR (6 mg/kg/d) was effective and safe in a 2-year study in conjunction with a regimen of cyclosporine (CsA), basiliximab, and corticosteroids. MethodsWe compared 40 living-related kidney recipients administered MZR (6 mg/kg/d), CsA (7 mg/kg/d), prednisolone (maintenance dose 10 mg/d), and basiliximab (20 mg/body) with control group (n = 38) treated with CsA, mycophenolate mofetil (MMF; 25 mg/kg/d), basiliximab, and corticosteroids. ResultsThe 4-year graft survival rates for the MZR vs MMF groups were 92.5% vs 94.7%, respectively, with serum creatinine levels of 1.66 ± 1.0 mg/dL vs 1.41 ± 0.42 mg/dL at 3 years, and 1.72 ± 1.16 mg/dL vs 1.56 ± 1.26 mg/dL at 4 years. There was no significant difference in serum creatinine levels between the 2 groups. The MZR group demonstrated a significantly higher rate of elevated serum uric acid values (29.7%). The numbers of patients treated with allopurinol at 4 years were 11/37 (29.7%) for MZR vs 2/36 (5.6%) for the MMF subjects (P < .05). Mean serum uric acid levels of the MZR vs MMF group at 4 years were 7.1 ± 1.9 mg/dL vs 7.0 ± 1.6 mg/dL, respectively (NS). There was no significant difference between the 2 groups regarding bone marrow suppression or liver dysfunction. Severe cytomegalovirus infection was not observed at 3 and 4 years in either group. There were no severe gastrointestinal symptoms among the MZR or the MMF group at 3 or 4 years. ConclusionsThe combination of high-dose MZR with CsA, basiliximab, and corticosteroids displayed excellent results over a 4-year follow-up.

Inflammatory Cells in Tissues of Gout Patients and Their Correlations with Comorbidities

Background:The major pathological finding of gout is the deposition of monosodium urate monohydrate (MSU) crystals with inflammatory infiltrate in the tissue. There have been many reports of in vitro analysis of inflammatory mechanism and comorbidities in gout. However, the associations of immune response cells and comorbidities of gout have not been well documented. Our studies aimed to examine the immune cell types and quantity in gout tissues, and to define the association of individual cell type with comorbidities.Methods:Surgically resected or biopsied tissues from 48 patients diagnosed as gout were used for this study. Cell count was performed on Hemotoxylin and Eosin stained sections for macrophages, plasma cells, neutrophils and on immunostained slides for T and B lymphocytes.Results:Hyperlipidemia, hypertension and diabetes mellitus were seen in 70.8%, 87.5% and 37.5% of patients, respectively. There were 35.6% and 37.8% of patients who admitted history of smoking and alcohol intake, respectively. Mean serum uric acid level was 8.5 mg/dl. The average body mass index was 30.1 kg/m2. H&E stained tissue sections demonstrated the crystalline deposits rimmed by palisading multinucleated giant cells, macrophages, neutrophils, plasma cells, T and B cells. Significant correlations between the clinical features and tissue inflammatory cells were observed in hyperlipidemia with number of T cells (p = 0.0363), hypertension with number of T cells and B cells (p = 0.0138 and 0.0033, respectively), diabetes mellitus with macrophages (p = 0.0016), and uric acid level with giant cells (p = 0.0088). Conclusion:Comorbidity factors including hyperlipidemia, hypertension and diabetes are significantly associated with the inflammatory cells in the tissues.

Association of Serum Uric Acid and Cardiovascular Disease in Healthy Adults

Studies in different populations with high risk for cardiovascular disease (CVD) have shown an association between serum uric acid (SUA) and CVD. However, only a few studies have demonstrated such an association in healthy populations. The aim of this study was to investigate the association between SUA and CVD in a cohort of men and women without diabetes or CVD. A retrospective study was conducted, with a mean 4.8-year follow-up. The outcome was the occurrence of a cardiovascular event, defined as the diagnosis of ischemic heart disease, acute coronary syndrome, acute myocardial infarction, or ischemic stroke. Mean SUA levels were 6.2 ± 1.1 mg/dl for men (n = 6,580) and 4.4 ± 1.1 mg/dl for women (n = 2,559). For women, the rate of CVD occurrence was 11.6% for the highest quartile of SUA level, compared with 5.0% to 6.5% for the lower 3 quartiles. For men, the rate of CVD occurrence was 14.0% for the highest quartile of SUA level, compared with 10.8% for the lowest quartile. The hazard ratio for CVD, adjusted for age, serum creatinine level, body mass index, systolic blood pressure, low-density lipoprotein cholesterol level, triglyceride level, plasma fasting glucose, physical activity, cardiovascular family history, use of diuretics, and current smoking, was 1.24 (95% confidence interval 1.08 to 1.41) for women and 1.06 (95% confidence interval 1.00 to 1.13) for men (p for interaction = 0.04). In conclusion, the strong association of SUA levels with CVD in women, compared with the much lesser degree in men, highlights the necessity of stratifying by gender in investigations of cardiovascular risk factors and supports exploration of SUA as a marker of CVD risk in healthy populations.

Preservation of Renal Function during Gout Treatment with Febuxostat: A Quantitative Study

Background: Hyperuricemia can accelerate renal decline associated with aging. Chronic kidney disease is frequently seen in patients with hyperuricemia and gout. Objectives: Assess the impact of urate–lowering therapy on renal function in subjects with gout who were treated with febuxostat for ≤ 48 months. Methods: Subjects from 2 phase 3 clinical studies were enrolled in the phase 3, long–term, open–label Febuxostat/Allopurinol Comparative Extension Long–Term (EXCEL) study. In the EXCEL study, 1086 subjects initially were treated with febuxostat 80 or 120 mg daily, or allopurinol 300 mg daily. The subjects were permitted to switch between doses of febuxostat and/or allopurinol during the first 6 months of treatment to achieve and maintain a serum uric acid (SUA) level ≥ 3 to < 6 mg/dL. For the analysis presented in this article, data from 551 subjects who received only febuxostat throughout the duration of both the phase 3 and EXCEL studies (≤ 48 months) were used to determine the impact of SUA reduction on estimated glomerular filtration rates (eGFRs). Results: At baseline of the 2 original phase 3 studies, subjects' mean SUA level was 9.8 mg/dL. Greater sustained decreases in subjects' SUA levels were associated with less renal function decline (P < 0.001)by statistical modeling. The study data predicted that for every 1 mg/dL of chronic reduction of SUA level in subjects with gout, there would be a preservation of 1.15 mL/min of eGFR. Conclusion: Sustained urate–lowering therapy with febuxostat appears to impede renal decline in patients with gout. The results discussed in this article support similar observations previously reported in 116 hyperuricemic subjects with gout who received febuxostat for ≤ 5 years.

Duration of Prophylactic Therapy Affects the Frequency of Gout Flare

Objective. To evaluate the effect of prophylactic therapy on gout flare during urate lowering treatment. Methods. We retrospectively examined the data derived from 59 patients who had been treated with allopurinol for more than six months after stopping prophylactic medication at our rheumatology clinic. Demographic data (age, sex, disease duration, tophi and comorbidity), clinical and laboratory features, including presence of gout flare during urate lowering treatment, dose of allopurinol, serum uric acid level and creatinine clearance at initiation and six months later, were collected. For the subgroup analysis, the same data were collected in 46 patients who had been followed up at one year after stopping prophylactic medication. Results. Twenty-eight patients among 59 (47.4%) had experienced at least 1 gouty attack during urate lowering therapy. The mean duration of prophylactic medication was not different between the flare group (3.8 months) and the nonflare group (5.9 months, p=0.617). Six months later, the mean serum uric acid level was 6.3 mg/dL (6.1 mg/dL vs. 6.5 mg/dL). According to the duration of prophylactic treatment (<6 months, ≥6 months), there were more frequent flares in the <6 months group than in the ≥6 months group (51.2% vs. 38.9% in the six month followup group, 70.6% vs. 50% in the one year follow-up group). Conclusion. Prophylactic medication for more than six months could be a favorable factor for the prevention of recurrent gout flare during urate lowering treatment.

Serum Uric Acid and Its Association with Coronary Artery Disease

Background: Few studies have assessed the relation of uric acid level with the severity of coronary artery disease (CAD). This study investigated the association between high uric acid levels with the presence and severity of CAD.Materials and Methods: This study was designed as an observational cohort study. The study was composed of 180 patients admitted at our institution due to symptoms related to CAD. Patients having angiographic evidence of stenosis in coronary artery were as case group and without stenosis control group. Patients with high uric acid (hyperuricemia) were defined as serum uric acid concentration ?7.0mg/dl or ?420 ?mol/L in men and ?6mg/dl or ?360 ? mol/L in women. The presence of CAD has been defined as the Gensini score being ?1. Results: There was a statistically significant difference between the mean uric acid levels of patients with and without CAD (358.23±71.11 ?mol/l vs251.32±54.92 ?mol/l respectively, p&lt;0.001). There was a statistically significant difference between ejection fraction of patients with and without CAD (54.50±9.25 vs. 63.16±6.56 respectively, p?0.001). Spearman correlation analysis demonstrated a positive correlation between the serum uric acid level and the severity of CAD (p=?0.001, r=0.39). When patients were classified into four groups according to their Gensini score, mean serum uric acid level was found to be significantly increased across the tertiles, and a statistically significant difference was detected between the tertiles (p= ?0.001). Conclusion: In conclusion, a significant association has been found between serum uric acid level and the presence and severity of CAD. In addition to the evaluation of conventional risk factors in daily clinical practice, the measurement of uric acid level might provide significant prognostic benefits in terms of global cardiovascular risk and management of the patients. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12206 Cardiovasc. j. 2012; 5(1): 12-17

An association between uric acid levels and renal arteriolopathy in chronic kidney disease: a biopsy-based study

Uric acid (UA) can induce renal arteriolopathy in animal models. Whether there is an association between UA and renal arteriolopathy in patients with chronic kidney disease (CKD) is unknown. Here, we examined the cross-sectional association of serum UA levels with renal arteriolar hyalinosis and wall thickening. Arteriolar parameters were assessed by semiquantitative grading (max: grade 3) of arterioles in 167 patients with CKD (mean age, 42.4 years; 86 men and 81 women) who underwent renal biopsy. The mean serum UA level was 6.4 mg dl(-1). We observed hyalinosis in 94 patients (56%) and wall thickening in 119 patients (71%). As the UA level tertile increased, the proportion of higher-grade (grade 2 and 3) hyalinosis and wall thickening increased (hyalinosis, P<0.0001 and wall thickening, P=0.0002, for trend). Multiple logistic analysis adjusted for age ≥40 years, sex, hypertension status, diabetes mellitus status and estimated glomerular filtration rate <60 ml min(-1) per 1.73 m(2) showed that hyperuricemia (UA ≥7 mg dl(-1)) was significantly associated with a higher risk of hyalinosis (adjusted odds ratio: 3.13; 95% confidence interval: 1.23-7.94; P=0.02) and higher-grade (equal to or higher than the mean value) wall thickening (adjusted odds ratio: 2.66; 95% confidence interval: 1.11-6.38; P=0.03). Hence, these results suggest that hyperuricemia may be related to renal arteriolar damage in patients with CKD.

Uric acid is associated with nutritional status in maintenance hemodialysis patients

Purines, mainly contained in meats, are metabolized finally to uric acid in humans. Although digestion of meat is impaired in end-stage renal disease patients on hemodialysis owing to anorexia and decreased taste, hyperuricemia is common in these patients. In this cross-sectional study, we analyzed demographic characteristics, normalized protein nitrogen appearance (nPNA), serum albumin concentration, and serum uric acid levels and other laboratory parameters in sixty patients on maintenance hemodialysis. There were 33 (55%) males and 27 (45%) females. The mean age was 62.9±14.3 years and the mean body mass index was 22.7±3.8 kg/m 2 . The mean serum uric acid level was 7.2±1.2 mg/dL, with the range of 5.1–10.8 mg/dL. There was a statistically significant correlation between serum uric level and nPNA ( p < 0.05). The serum uric acid level was also positively correlated with blood urea nitrogen level ( p < 0.01) and serum phosphorus level ( p < 0.05). Our results suggest that serum uric acid level is associated with nutritional status, and might be a possible marker for protein nutrition in maintenance hemodialysis patients.

A STUDY OF SERUM URIC ACID IN DIABETES MELLITUS AND PREDIABETES IN A SOUTH INDIAN TERTIARY CARE HOSPITAL

Abstract Background: Several epidemiologic studies have reported that high serum levels of uric acid are strongly associated with prevalent health conditions such as obesity, insulin resistance, metabolic syndrome, essential hypertension and renal disease. This study aimed to investigate the level of serum uric acid in Type 2 diabetes mellitus, pre-diabetics and non diabetics (controls) in south Indian population. Methods: Uric acid level was measured by Uricase-PAP methodology in patients with Diabetes (n=71)/Pre diabetes (n=12)/ Control groups (n=34). Using ANOVA test, uric acid levels in the above three groups were compared based on age, sex and other factors which can affect uric acid level. Results: The mean serum uric acid level was lower in control group (3.84mg/dl), rose in pre-diabetics (4.88mg/dl) and again decreased in diabetics (3.78mg/dl). P value comparing control and pre-diabetes was 0.009, p-value comparing pre-diabetes and diabetes was 0.003 and p-value comparing control and diabetes was 0.982 (p value &lt;0.05 being significant). Conclusion: The serum uric acid level being higher in pre-diabetes than controls and lower in diabetes mellitus than pre-diabetes may serve as a potential inexpensive biomarker of deterioration of glucose metabolism.

Lack of association between serum uric acid levels and outcome in acute ischemic stroke

BackgroundThe prognostic value of serum uric acid (UA) in acute ischemic stroke is controversial. The aim of this study is to further analyse the relation between UA and outcome after acute ischemic stroke. MethodsWe analysed UA levels in blood samples collected within 6h of stroke onset from patients included in the placebo arm of the US and Canadian Lubeluzole Ischemic Stroke Study (LUB-INT-9). We compared mean serum UA levels in patients with and without early neurological improvement (≥4 versus <4 points improvement on NIHSS after 5days) and in patients with good functional and poor functional outcome (mRS 0–2 versus mRS 3–6). Multivariable logistic regression analyses were performed to adjust for possible confounders. ResultsUA levels of 226 patients were available for analysis. Mean serum UA levels were not significantly higher in patients with than without early neurological improvement (0.33mmol/L versus 0.30mmol/L, p=0.070). The difference between patients with good and patients with poor functional outcome was borderline statistically significant (0.34mmol/L versus 0.31mmol/L, p=0.050). After adjustment for confounders, higher serum UA levels were neither associated with early neurological improvement OR (1.30, 95% CI 0.98–1.73, p=0.069), nor with a good functional outcome (OR 1.09, 95% CI 0.72–1.65, p=0.690). ConclusionWe found no association between admission serum UA levels and both short- and long-term outcome in acute ischemic stroke.

English

INTRODUCTION: Uric acid (UA) contributes to the development of human vascular disease and atherosclerosis through a pro-inflammatory pathway. Highly-sensitive C- reactive protein (hs-CRP) also has emerged as the most exquisitely sensitive systemic marker of inflammation and a powerful predictive marker of future cardiovascular risk. In this study we estimated the levels of serum uric acid and hs- CRP in patients with ischaemic heart disease and association between them. METHODS: Study was carried out among fifty (50) newly diagnosed patients of ischaemic heart disease and fifty (50) age and sex matched healthy controls. Serum uric acid, hs-CRP, random glucose, urea, creatinine and cardiac troponin-I were measured. RESULTS: The mean serum uric acid level in the control group was 4.66 ± 0.97 mg/dl and in case group was 6.86 ± 0.90 mg/dl. Mean hs-CRP level in control group was 0.19 ± 0.09 mg/dl, in case group was 5.14 ± 2.11 mg/dl. There was a positive association between UA and hs-CRP but the correlation was statistically not significant (p > 0.05). CONCLUSION : Our study indicated that there was a statistically significant association between ischaemic heart disease patients and elevated serum UA and serum hs-CRP and hence a strong role in the pathophysiology of ischaemic heart disease.

Association of uric acid with progression to preeclampsia and development of adverse conditions in gestational hypertensive pregnancies

Preeclampsia is a serious pregnancy complication. Gestational hypertension is a common first clinical presentation of preeclampsia. Little is known about which clinical risk factors are associated with the progression from gestational hypertension to preeclampsia. In a retrospective cohort study of 249 singleton pregnant women with an initial presentation of gestational hypertension in an obstetric hospital, we assessed which routinely available clinical risk factors are associated with the progression to preeclampsia and the development of adverse maternal or infant conditions. The mean serum uric acid level at the initial presentation of gestational hypertension was significantly higher comparing patients who later progressed to preeclampsia to those who did not (5.06 vs. 4.59 mg/dl, P < 0.01). Lower gestational age and higher serum uric acid level at the initial presentation of gestational hypertension and subsequent need for antihypertensive drug treatment for blood pressure (BP) control were associated with significantly increased risks of progression to preeclampsia, and development of adverse maternal or infant conditions. One standard deviation (s.d.) increase in serum uric acid level was associated with 2.3-fold increased odds of progression to preeclampsia (adjusted odds ratio (aORs) 2.33 (95% confidence interval (CI) 1.45-3.74)), and 1.5-fold increased odds of developing clinically significant adverse maternal or infant conditions (aOR 1.49 (1.03-2.17)) irrespective of the progression to preeclampsia. Higher serum uric acid levels at the initial presentation of gestational hypertension may indicate heightened risk of progression to preeclampsia and development of adverse maternal/infant conditions.

Uric Acid Level and Elevated Blood Pressure in US Adolescents

Uric acid is associated with cardiovascular disease and cardiovascular disease risk factors in adults, including chronic kidney disease, coronary artery disease, stroke, diabetes mellitus, preeclampsia, and hypertension. We examined the association between uric acid and elevated blood pressure in a large, nationally representative cohort of US adolescents, a population with a relatively low prevalence of cardiovascular disease and cardiovascular disease risk factors. Among 6036 adolescents 12 to 17 years of age examined in the 1999-2006 National Health and Nutrition Examination Survey, the mean age was 14.5 years, 17% were obese (body mass index: ≥95th percentile), and 3.3% had elevated blood pressure. Mean serum uric acid level was 5.0 mg/dL, and 34% had a uric acid level ≥5.5 mg/dL. In analyses adjusted for age, sex, race/ethnicity, and body mass index percentile, the odds ratio of elevated blood pressure, defined as a systolic or diastolic blood pressure ≥95th percentile for age, sex, and height, for each 0.1-mg/dL increase in uric acid level was 1.38 (95% CI: 1.16-1.65). Compared with <5.5 mg/dL, participants with a uric acid level ≥5.5 mg/dL had a 2.03 times higher odds of having elevated blood pressure (95% CI: 1.38-3.00). In conclusion, increasing levels of serum uric acid are associated with elevated blood pressure in healthy US adolescents. Additional prospective studies and clinical trials are needed to determine whether uric acid is merely a marker in a complex metabolic pathway or causal of hypertension and, thus, a potential screening and therapeutic target.

Excellent Results With High-Dose Mizoribine Combined With Cyclosporine, Corticosteroid, and Basiliximab in Renal Transplant Recipients: Multicenter Study in Japan

We performed a multicenter study in Japan to assess the efficacy and safety of immunosuppressive therapy with high-dose mizoribine (MZR; 6 mg/kg) combined with basiliximab (Bas), cyclosporine (CyA), and a corticosteroid in 90 patients. MZR was adjusted to maintain a target trough level of 1 to 2 μg/mL. CyA was started at 7 mg/kg to maintain blood levels in the target therapeutic range of 200 ng/mL (trough [C0]), 1200 ng/mL (2-hour post-dose [C2]), and 6000 ng·h/mL (area under the curve0–9). Bas (20 mg/body weight) was administered on the day of transplantation and on postoperative day 4. Rejection was diagnosed by episode and protocol biopsies. Cytomegalovirus (CMV) antigenemia (direct immunological staining of leukocytes using peroxidase-labeled monoclonal antibody [C7-HRP]) levels were measured every 2 weeks for 6 months. At 12 months, all patients and grafts were surviving except for one death from infection: the 1-year patient and graft survival rate was 98.9%. The acute rejection rate was 21.1%. The mean serum creatinine level at 1 year was 1.51 ± 0.61 mg/dL. The incidence of CMV disease was 0% with 28.9%, CMV antigenemia and 5.6%, ganoyclovir treatment. The incidence of BK virus disease was 2.2%. The mean serum uric acid level was 7.15 ± 1.79 mg/dL at 1 month and 7.06 ± 1.78 mg/dL at 3 months. We observed that a high-dose MZR regimen in combination with CyA, Bas, and corticosteroid was safe and effective to reduce the frequency of CMV and BK virus-related events in renal transplant recipients.