The Shared Genetic Basis of Hyperuricemia, Gout, and Kidney Function
Summary: Increased urate levels and gout correlate with chronic kidney disease with consensus that the primary driver of this relationship is reduced kidney function. However, a comparison of results of genome-wide association studies in serum urate levels and kidney function indicate a more complex situation. Approximately 20% of loci are shared —comprised of those in which the urate-raising allele associates with reduced kidney function, the vice versa situation, and those in which the signals/alleles are different. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - November 1, 2020 Category: Urology & Nephrology Authors: Megan P. Leask, Nicholas A. Sumpter, Alexa S. Lupi, Ana I. Vazquez, Richard J. Reynolds, David B. Mount, Tony R. Merriman Source Type: research
Uric Acid and Urate in Urolithiasis: The Innocent Bystander, Instigator, and Perpetrator
Summary: Uric acid is an end product of purine metabolism in human beings. An unusual and still unexplained phenomenon is that higher primates have relatively high uric acid levels in body fluids owing to a combination of absence of degradation and renal retention. The physiologic purpose of high uric acid levels still is enigmatic, but the pathobiologic burden is a variety of crystallopathies owing to the low aqueous solubility of uric acid such as gouty arthritis and acute uric acid nephropathy. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - November 1, 2020 Category: Urology & Nephrology Authors: Emmanuel Adomako, Orson W. Moe Source Type: research
Hyperuricemia in Kidney Disease: A Major Risk Factor for Cardiovascular Events, Vascular Calcification, and Renal Damage
Kidney disease, especially when it is associated with a reduction in estimated glomerular filtration rate, can be associated with an increase in serum urate (uric acid), suggesting that hyperuricemia in subjects with kidney disease may be a strictly secondary phenomenon. Mendelian randomization studies that evaluate genetic scores regulating serum urate also generally have not found evidence that serum urate is a causal risk factor in chronic kidney disease. Nevertheless, this is countered by a large number of epidemiologic, experimental, and clinical studies that have suggested a potentially important role for uric acid i...
Source: Seminars in Nephrology - November 1, 2020 Category: Urology & Nephrology Authors: A. Ahsan Ejaz, Takahiko Nakagawa, Mehmet Kanbay, Masanari Kuwabara, Ada Kumar, Fernando E. Garcia Arroyo, Carlos Roncal-Jimenez, Fumihiko Sasai, Duk-Hee Kang, Thomas Jensen, Ana Andres Hernando, Bernardo Rodriguez-Iturbe, Gabriela Garcia, Dean R Tolan, La Source Type: research
Introduction: Gout and the Kidney
Hyperuricemia, gout, and the kidney are tightly intertwined. A reduced urinary fractional excretion of uric acid thus is the most common underlying mechanism in hyperuricemia and gout,1 however, as reviewed in this issue of Seminars in Nephrology, it is increasingly clear that reduced intestinal secretion resulting from ABCG2 dysfunction can lead to a “renal overload” mechanism of hyperuricemia.2 A combination of genome-wide association studies and transport physiology also has led to the identification and characterization of the major transporters involved with urate reabsorption and secretion, providing an increasin...
Source: Seminars in Nephrology - November 1, 2020 Category: Urology & Nephrology Authors: David B. Mount Source Type: research
Molecular Pathophysiology of Uric Acid Homeostasis
Summary: Uric acid, the end product of purine metabolism, plays a key role in the pathogenesis of gout and other disease processes. The circulating serum uric acid concentration is governed by the relative balance of hepatic production, intestinal secretion, and renal tubular reabsorption and secretion. An elegant synergy between genome-wide association studies and transport physiology has led to the identification and characterization of the major transporters involved with urate reabsorption and secretion, in both kidney and intestine. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - November 1, 2020 Category: Urology & Nephrology Authors: Christopher Estiverne, Asim K. Mandal, David B. Mount Source Type: research
The Management of Gout in Renal Disease
Gout, a debilitating inflammatory arthritis, currently affects more than 9 million Americans. Hyperuricemia, the laboratory abnormality associated with the development of gout, also occurs in a significant number of patients with chronic kidney disease (CKD), a condition that affects approximately 14% of the US population. Several recent studies have attempted to provide a definitive link between the presence of hyperuricemia and progression of CKD; however, the treatment of asymptomatic hyperuricemia in CKD is not supported by recent randomized controlled trials. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - November 1, 2020 Category: Urology & Nephrology Authors: Christopher Estiverne, David B. Mount Source Type: research
Editorial Board
(Source: Seminars in Nephrology)
Source: Seminars in Nephrology - November 1, 2020 Category: Urology & Nephrology Source Type: research
Table of Contents
(Source: Seminars in Nephrology)
Source: Seminars in Nephrology - November 1, 2020 Category: Urology & Nephrology Source Type: research
Acute Kidney Injury in COVID-19: The Chinese Experience
Coronavirus disease 2019 (COVID-19) is spreading rapidly worldwide. Here, we review recently published studies on COVID-19-associated acute kidney injury (AKI) in China. The pooled incidence of AKI in all reported COVID-19 patients was 6.5%, with a much higher rate in patients from the ICU (32.5%). AKI is associated with the severity of COVID-19 and the mortality rates, which is similar to other kidney abnormalities including proteinuria and hematuria. The renal tubule is the main site of injury in COVID-19 patients, and the etiology of renal impairment in COVID-19 patients is likely diverse and multifactorial. (Source: Se...
Source: Seminars in Nephrology - September 3, 2020 Category: Urology & Nephrology Authors: Xizi Zheng, Youlu Zhao, Li Yang Source Type: research
Acute Kidney Injury in Asia: Disease Burden
Acute kidney injury (AKI) is a common and critical clinical disorder with non-negligible morbidity and mortality and remains a large public health problem. Asia, as the world's largest and most populous continent, is crucial in eliminating unsatisfactory outcomes of AKI. The diversities in climate, customs, and economic status lead to various clinical features of AKI across Asia. In this review, we focus on the epidemiologic data and clinical features of AKI in different Asian countries and clinical settings, and we show the huge medical and economic burden of AKI in Asian countries. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - September 1, 2020 Category: Urology & Nephrology Authors: Junwen Huang, Damin Xu, Li Yang Source Type: research
Community-Acquired AKI in Asia: An Update
Community-acquired acute kidney injury (CA-AKI) is the dominant form of AKI encountered in developing countries in Asia. Economic disparities, variations in access to health care services, geographic conditions, environmental risk factors, and sociocultural circumstances shape the causes and outcomes of CA-AKI. Infections, drugs, plant and chemical toxins, envenomations, and obstetric complications are common causes of CA-AKI. Previously healthy young individuals who often work outdoors in fields or farms are exposed to a wide variety of work-related or environmental risk factors for CA-AKI. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - September 1, 2020 Category: Urology & Nephrology Authors: Vivek Kumar, Vivekanand Jha Source Type: research
Diagnostic Challenges of Acute Kidney Injury in Asia
Summary: Early diagnosis of acute kidney injury (AKI) is an important step to improve AKI outcome. In Asia, several distinct conditions of this region such as environment (tropical climate), socioeconomic status (high-resource and low-resource settings), process of care (shortage of nephrologists), exposure factors (specific tropical infections such as leptospirosis, malaria, dengue), and inherent factor (aging) make the diagnosis of AKI in Asia more challenging than in other parts of the world. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - September 1, 2020 Category: Urology & Nephrology Authors: Nattachai Srisawat, Nuttha Lumlertgul, Win Kulvichit, Nicha Thamrongsat, Sadudee Peerapornratana, Somchai Eiam-Ong, Kriang Tungsanga Source Type: research
Prevention and Therapy of AKI in Asia: A Big Challenge
Summary: Asia is the largest and most populous continent and has huge differences in socioeconomic status, development, and health care between the different countries and regions within each country. This manifests in the varied causes of acute kidney injury (AKI), particularly higher rates of community-acquired AKI and in the differential access to health care for the population. Because of resource limitations, prevention and treatment of AKI is a difficult challenge. This review highlights the differences in AKI in Asia compared with the developed world and discusses prevention and treatment of AKI within the context o...
Source: Seminars in Nephrology - September 1, 2020 Category: Urology & Nephrology Authors: Ajay Kher, Vijay Kher Source Type: research
Acute Kidney Injury in Sepsis: Evidence From Asia
Summary: Acute kidney injury (AKI) is one of the most frequent complications of sepsis. Because sepsis and AKI synergistically worsen the outcomes of critically ill patients, better therapeutics against septic AKI urgently are required. In addition to the complexity of disease mechanisms of both sepsis and AKI, there is substantial regional variation in clinical practice, which further hampers the development of new treatments for septic AKI. To overcome this problem, evidence accumulation is necessary for building the foundation for developing novel septic AKI treatments. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - September 1, 2020 Category: Urology & Nephrology Authors: Kohei Yoshimoto, Yohei Komaru, Masao Iwagami, Kent Doi Source Type: research
RRT Selection for AKI Patients With Critical Illness
Acute kidney injury (AKI) is a critical burden on intensive care units in Asia. Renal replacement therapy (RRT) acts as strong supportive care for severe AKI. However, various RRT modalities are used in Asia because of the diversity in ethics, climate, geographic features, and socioeconomic status. Extracorporeal blood purification is used commonly in Asian intensive care units; however, intermittent RRT is preferred in developing countries because of cost and infrastructure issues. Conversely, continuous RRT is preferred in developed countries, indicating the predominance of hospital-acquired AKI patients with complicatio...
Source: Seminars in Nephrology - September 1, 2020 Category: Urology & Nephrology Authors: Ryo Matsuura, Kent Doi, Yoshifumi Hamasaki, Masaomi Nangaku Source Type: research
