Monday, 16 Sep 2019

You are here

Hyperuricemia, Death & Kidney Disease

In a recent study published in the Journal of the American Geriatrics SocietyTaiwan investigators examined the Annual Geriatric Health Examination Program database (2006 to 2010) to estimate the all-cause, cardiovascular, and cancer mortality risks associated with serum uric acid levels in elderly adults. They found (as expected) that men have higher uric acid levels than women and that mean levels increase with age (P < 0.001). (Citation source http://buff.ly/1EmY4Jo )

They also found that high serum uric acid was an independent risk factor for all-cause and cardiovascular mortality, compared to those with normal levels in both men and women. The strongest association was found for cardiovascular mortality. This association was independent of other cardiovascular risk factors - hypertension,diabetes mellitus,hyperlipidemia, andkidney disease.

Another recent review of chronic kidney disease (CKD) and hyperuricemia points out that CKD has become a global public health problem as these patients are at risk for end-stage renal disease, cardiovascular disease, and premature death. The most common risk factors for CKD are obesity, HTN and the metabolic syndrome, which are all strongly associated with hyperuricemia. In addition to renal stone formation, hyperuricemia may contribute to CKD by deposition and local or systemic inflammatory effects, renovascular and endothelial effects and possibly by contributing to hypertension or metabolic disease.

Many evidence-based studies have suggested that uric acid itself is an independent risk factor for CKD by increasing inflammation and CKD progression, but the issue is still shrouded in controversy. The prevalence of CKD continues to increase, and it is likely that the management of hyperuricemia and gout will continue to be a challenge in these patients.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Modifiable Risk Factors for Hyperuricemia

Choi and colleagues have shown that four modifiable risk factors (BMI, the DASH diet, alcohol use, and diuretic use) could individually account for a notable proportion of observed hyperuricemia. 

Researchers examine modifiable risk factors for hyperuricemia and how this could be prevented through risk factor modification in the general population.

Opioids Overused in Acute Gout

Opioids were commonly given to patients as a treatment for acute gout attacks, despite the availability of other effective and appropriate therapies, a retrospective study found.

Allopurinol Fails to Curtail Hypertension

Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. A novel trial presented at EULAR 2019 last week assessed whether the use of urate-lowering therapy (ULT) would control hypertension in those at risk; however, results of this trial were largely negative.

Hypertension is one of the many comorbidities that plagues gout patients.

Allopurinol Fails to Curtail Hypertension

A novel trial presented at EULAR 2019 last week assessed whether the use of urate-lowering therapy (ULT) would control hypertension in those at risk; however, results of this trial were largely negative.

Hypertension is one of the many comorbidities that plagues gout patients.

Updated 2018 EULAR Recommendations for the Diagnosis of Gout

The first EULAR recommendations for the diagnosis of gout were published in 2006. A task force was formed and following a systematic review, they voted unanimously for changes in all items of the 2006 recommendations.