Hyperuricemia, Acute and Chronic Kidney Disease, Hypertension, and Cardiovascular Disease: Report of a Scientific Workshop Organized by the National Kidney Foundation

Publication date: Available online 27 February 2018 Source:American Journal of Kidney Diseases Author(s): Richard J. Johnson, George L. Bakris, Claudio Borghi, Michel B. Chonchol, David Feldman, Miguel A. Lanaspa, Tony R. Merriman, Orson W. Moe, David B. Mount, Laura Gabriella Sanchez Lozada, Eli Stahl, Daniel E. Weiner, Glenn M. Chertow Urate is a cause of gout, kidney stones, and acute kidney injury from tumor lysis syndrome, but its relationship to kidney disease, cardiovascular disease, and diabetes remains controversial. A scientific workshop organized by the National Kidney Foundation was held in September 2016 to review current evidence. Cell culture studies and animal models suggest that elevated serum urate concentrations can contribute to kidney disease, hypertension, and metabolic syndrome. Epidemiologic evidence also supports elevated serum urate concentrations as a risk factor for the development of kidney disease, hypertension, and diabetes, but differences in methodologies and inpacts on serum urate concentrations by even subtle changes in kidney function render conclusions uncertain. Mendelian randomization studies generally do not support a causal role of serum urate in kidney disease, hypertension, or diabetes, although interpretation is complicated by nonhomogeneous populations, a failure to consider environmental interactions, and a lack of understanding of how the genetic polymorphisms affect biological mechanisms related to urate. Although...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research