Hyperuricemia in chronic glomerulonephritis: clinical and functional features

  • Authors: Murkamilov I.T1,2, Sabirov I.S3, Fomin V.V4, Murkamilova Z.A5, Aitbaev K.A6, Imanov B.Z.6, Aydarov Z.A1
  • Affiliations:
    1. Kyrgyz State Medical Academy n.a. І.К. Akhunbaev
    2. National Center for Cardiology and Therapy n.a. Academician Mirsaid Mirrakhimov under the Ministry of Health of the Kyrgyz Republic
    3. Kyrgyz Russian Slavic University n.a. The First President of Russia B.N. Yeltsin
    4. FSBEI HE "First Moscow State Medical University n.a. І.М. Sechenov"
    5. Center for Family Medicine № 7
    6. Scientific Research Institute of Molecular Biology and Medicine under the National Center for Cardiology and Therapy of the Ministry of Health of the Kyrgyz Republic
  • Issue: No 1 (2018)
  • Pages: 31-37
  • Section: Articles
  • URL: https://journals.eco-vector.com/2075-3594/article/view/272773
  • ID: 272773

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Purpose. To evaluate clinical and functional manifestations of chronic glomerulonephritis against the background of the development of hyperuricemia. Material and Methods. і63 patients (і02 men and 41 women) with chronic glomerulonephritis (CGN) at the predialysis stage of the disease aged from 17 to 71 years were examined. The study inclusion criteria was an increase in the plasma uric acid (PUA) concentration >0.42 mmol/l for men, and >0.36 mmol/l for women. All patients examined were divided into two groups depending on gender: group 1-men (n=102); group 2-women (n=41). The groups were matched by age, duration of CGN, parameters of hemodynamics and lipid spectrum. In addition to the clinical and laboratory tests, all patients underwent echocardiographic evaluation of structural changes in the heart. Results. Significant increases in the diameter of the ascending aorta (3.5і±0.43 vs 3.і4±0.25 cm, P<0.05), longitudinal size of the left atrium (3.57±0,47 vs. 3.36±0.39 cm, P<0.05), FINAL systolic (3.40±0.56 vs. 3.14±0.35 cm, P<0.05) and diastolic dimensions of the left ventricle (LV) (5.25±0.51 vs. 4.93±0.41 cm, P<0.05), as well as an increase in the LV mass index were detected in patients of group I (men) as compared with group 2 (women). In the group 2, A significant decrease in the hemoglobin levels (114.9±22.3 vs. 140.2±24.5 g/l, P<0.05), the number of erythrocytes (3.99±0.52x1012/L versus 4.54±0.54x1012/L, P<0.05), PLATELETS (230.6±28.4 1 09/L versus 246.1±28.3x109/L, P<0.05 ), and a decrease in GFR (43.9 [22.9-68.3] vs 62.4 [29.2-92.4] ml/min, P<0.05) were found. Men had a direct relationship between serum uric acid (SUA) level and low-density lipoprotein cholesterol concentration (r=0.254; P=0.029) and inverse relationship with GFR (r=-0.264; P=0.029). In females, a positive relationship was observed between the SUA concentration and he diameter of the ascending aorta (r=0.493, P=0.012) and the value of LVMMI (r=0.327; P=0.046). Conclusions. In chronic glomerulonephritis atthe pre-dialysis stage of the disease, an increase in the serum uric acid concentration in men is accompanied by the appearance of structural changes in the left ventricle, in women - by the development of anemia and inhibition of the glomerular filtration rate.

Full Text

Restricted Access

About the authors

I. T Murkamilov

Kyrgyz State Medical Academy n.a. І.К. Akhunbaev; National Center for Cardiology and Therapy n.a. Academician Mirsaid Mirrakhimov under the Ministry of Health of the Kyrgyz Republic

Email: murkamilov.i@mail.ru
PhD in Medical Sciences, Nephrologist of the I Qualification Category, Teaching Assistant at the Department of Faculty Therapy Bishkek, Kyrgyzstan

I. S Sabirov

Kyrgyz Russian Slavic University n.a. The First President of Russia B.N. Yeltsin

Email: sabirov_is@mail.ru
Doctor of Medical Science, Professor, Head of the Department of Therapy № 2 in the Specialty "Medical Care" Bishkek, Kyrgyzstan

V. V Fomin

FSBEI HE "First Moscow State Medical University n.a. І.М. Sechenov"

Doctor of Medical Science, Professor, Head of the Department of Faculty Therapy № 1 Bishkek, Kyrgyzstan

Zh. A Murkamilova

Center for Family Medicine № 7

Nephrologist at the Centerfor Family Medicine № 7 Bishkek, Kyrgyzstan

K. A Aitbaev

Scientific Research Institute of Molecular Biology and Medicine under the National Center for Cardiology and Therapy of the Ministry of Health of the Kyrgyz Republic

Doctor of Medical Science, Professor, Head of the Laboratory of Pathological Physiology Bishkek, Kyrgyzstan

B. Zh Imanov

Scientific Research Institute of Molecular Biology and Medicine under the National Center for Cardiology and Therapy of the Ministry of Health of the Kyrgyz Republic

PhD in Medical Science, Leading Researcher at the Department of Ultrasound Examination SRI of Molecular Biology and Medicine under the NCCT of MH of KR Bishkek, Kyrgyzstan

Z. A Aydarov

Kyrgyz State Medical Academy n.a. І.К. Akhunbaev

Email: aydarov.ziabidin.65@mail.ru
Doctor of Medical Science, Professor, Head of the Department of Public Health and Healthcare Service Bishkek, Kyrgyzstan

References

  1. Мухин Н.А. Нефрология. Национальное руководство. Краткое издание. 2016:608 с.
  2. Etuk I.S., Anah M.U., Eyong M.E. Epidemiology and clinical features of acute glomerulonephritis in Calabar, Nigeria. Nigerian Journal of Physiological Sciences.2009;24:2. Doi: http://dx.doi.org/10.4314/njps.v24i2.52913.
  3. Locatelli F., Del Vecchio L., Luise M.C. Current and future chemical therapies for treating anaemia in chronic kidney disease. Expert Opinion on Pharmacotherapy. 2017;18(8) :781-788. doi: 10.1080/14656566. 2017.1323872.
  4. Hunsicker L.G., Adler S., Caggiula A., England B.K., Greene T., Kusek J.W., Rogers N.L., Teschan P.E. Predictors of the progression of renal disease in the Modification of Diet in Renal Disease Study. Kidney Int. 1997;51(6):1908-1919.
  5. Шальнова С.А., Деев А.Д., Артамонова Г.В. и др. Гиперурикемия и ее корреляты в российской популяции (результаты эпидемиологического исследования ЭССЕ-РФ). Рациональная фармакотерапия в кардиологии. 2014;10(2):153-159.
  6. Ланг Г.Ф. Гипертоническая болезнь. Л.: Медгиз, 1950. 496 с.
  7. Тареев Е.М. Гипертоническая болезнь. М.: «Медгиз», 1948. 153 с.
  8. Weiner D.E., Tighiouart H., Elsayed E.F. и др. Uric acid and incident kidney disease in the community.Journal of the American Society of Nephrology. 2008;19:6:1204-1211. doi: 10.1681/ASN.2007101075.
  9. Wang W., Bhole V.M., Krishnan E. Chronic kidney disease as a risk factor for incident gout among men and women: retrospective cohort study using data from the Framingham Heart Study [Electronic resource]. BMJ Open. 2015;5.URL: e006843.
  10. Johnson R.J., Kivlighn S.D., Kim Y.G. et al. Reappraisal of the Pathogenesis and consequences of hyperuricemia in hypertension, cardiovascular disease, and renal disease. Am J Kid Dis.1999;33(2):225-234.
  11. Мухин Н.А., Козловская Л.В., Фомин В.В. и др. Биомаркеры поражения почек у больных артериальной гипертензией с гиперурикемией: персонифицированный подход к оценке прогноза. Клиническая нефрология. 2014;4:16-20.
  12. Щербак А.В., Козловская Л.В., Бобкова И.Н. и др. Гиперурикемия и проблема хронической болезни почек. Терапевтический архив. 2013; 6:100-104.
  13. Ларина В.Н., Барт Б.Я., Ларин В.Г., Донсков А.С. Гиперурикемия и сердечно-сосудистый континуум. Клиническая медицина. 2013;1:11-15.
  14. Зверев Я.Ф., Брюханов В.М. Современные представления о механизмах почечного транспорта мочевой кислоты. Клиническая нефрология. 2016;1:49-58.
  15. Eleftheriadis T., Golphinopoulos S., Pissas G., Stefanidis I. Asymptomatic hyperuricemia and chronic kidney disease: Narrative review of a treatment controversial. Journal of Advanced Research. 2017;8(5):555-560. Doi: 10.1016/j. jare.2017.05.001.
  16. Ramirez M.E.G, Bargman J.M. Treatment of Asymptomatic Hyperuricemia in Chronic Kidney Disease: A New Target in an Old Enemy-A review. Journal of Advanced Research. 2017;8:5:551-554. Doi: https://doi.org/10.1016/j. jare.2017.04.006.
  17. Tsai C.W., Lin S.Y., Kuo C.C., Huang C.C. Serum Uric Acid and Progression of Kidney Disease: A Longitudinal Analysis and Mini-Review. PloS one. 2017;12:1.С. e0170393.
  18. Mahamat Abderraman G., Hamat I., Tondi Z.M.M. et al. Hyperuricemia in Patients with Chronic Renal Failure in the General Hospital of National Reference of N’Djamena (Chad). Open Journal of Nephrology.2017;7:9-18. doi: 10.4236/ojneph.2017.71002.
  19. Тареева И.Е. Нефрология. Руководство для врачей. 2000. 688 с.
  20. Елисеев М.С. Новые международные рекомендации по диагностике и лечению подагры. Научно-практическая ревматология. 2014; 52:2:141-146.
  21. Levey A.S., Stevens L.A., Schmid C.H. et al. A new equation to estimate glomerular filtration rate. Annals of internal medicine. 2009;150(9):604-612. PMID: 19414839.
  22. Devereux R.B., Alonso D.R., Lutas E.M. et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. The American journal of cardiology. 1986;57(6):450-458. PMID: 2936235.
  23. Mancia G., Fagard R., Narkiewicz K. et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Blood pressure. 2013;1;22(4):193-278. Doi: http://dx.doi.org/10.3109/08037051.2013.812549.
  24. Кочетов А.Г., Лянг О.В., Масенко В.П. и др. Методы статистической обработки медицинских данных. Методические рекомендации. М.: РКНПК. 2012. 42 с.
  25. Iwashima Y., Horio T., Kamide K. et al. Uric Acid, Left Ventricular Mass Index, and Risk of Cardiovascular Disease in Essential Hypertension. Hypertension 2006; 47; 195-202. https://doi.org/10.1161/01.HYP.0000200033.14574.14.
  26. Nicholls A., Snaith M.L., Scott J.T. Effect of estrogen therapy on plasma and urinary levels of uric acid. BMJ.1973;1(5851):449-451. PMID: 4689833.
  27. Елисеев М.С., Чикаленкова Н.А., Денисов И.С., Барскова В.Г. Факторы риска подагры: половые различия. Научно-практическая ревматология.2011;6:28-31.
  28. Carrero J.J. Gender differences in chronic kidney disease: underpinnings and therapeutic implications. Kidney Blood Press Res. 2010;33(5):383-392. doi: 10.1159/000320389.
  29. Cobo G., Hecking M., Port F.K. et al. Sex and gender differences in chronic kidney disease: progression to end-stage renal disease and hemodialysis. Clinical science. 2016;130:14:1147-1163. doi: 10.1042/CS20160047.
  30. Grupper A., Zeltser D., Etz-Hadar I. et al. Sex difference in the risk for exercise-induced albuminuria correlates with hemoglobin A1C and abnormal exercise ECG test findings. Cardiovascular diabetology.2017;16:1:79. Doi: https://doi.org/10.1186/s12933-017-0560-4.
  31. Qiu L., Cheng X., Wu J. et al. Prevalence of hyperuricemia and its retated risk factors in healthy aduts from Nothern and Northeastern Chinese provinces. BMC Public health. 2013;13: 664. DOI:https://doi.org/10.1186/ 1471-2458-13-664.
  32. Kazufumi N., Kunitoshi I., Taku I. et al. Hyperuricamia and cardiovascular rik factor clastering in a screened cohot in Okinava, Japan. Hypertens Res. 2004;27:227-233. Doi: https://doi.org/10.1291/hypres.27.227.
  33. Hare J., Johnson R. Uric acid predicts clinical outcomes in heart failure. Insights regarding the role of xantine oxidase and uric acid in disease pathophysiology. Circulation. 2003; 107:1951-1953. DOI:https://doi. org/10.1161/01.CIR.0000066420.36123.35.
  34. Kang D., Nakagawa Т., Feng L. et al. A role of uric acid in the progression of renal disease. J. Am. Soc. Nephrol. 2002;13(12):2888-2897. doi: 10.1097/01. ASN.0000034910.58454.FD.
  35. Yang Zhou., Li Fang., Lei Jiang. et al. Uric Acid Induces Renal Inflammation via Activating Tubular NF kB Signaling Pathway.PLoS One. 2012;7(6):e39738. D0I:https://doi.org/10.1371/journal.pone.0039738.
  36. Ryu E.S., Kim M.J., Shin H.S. et al. Uric Acid-induced Phenotypic Transition of Renal Tubular Cells as a Novel Mechanism of Chronic Kidney Disease. Am J Physiol Renal Physiol. 2013;304(5):F471-480. Doi:https:// doi.org/10.1152/ajprenal.00560.2012.
  37. HuangW.-Y, Li Z.-G. RGC-32 Mediates Transforming Growth FactorB2-induced Epithelial-Mesenchymal Transition in Human Renal Proximal Tubular. Cell Biol Chem. 2009;284(14): 9426-9432. doi: 10.1074/jbc. M900039200.
  38. Nakagawa T., Mazzali M., Kang D.H. et al. Uric acid-a uremic toxin?Blood Purif. 2006; 24:67-70. DOI: https://doi.org/10.1159/000089440.
  39. Osgood K., Krakoff J., Thearle M. Serum Uric Acid Predicts Both Current and Future Components of the Metabolic Syndrome. Metab Syndr Relat Disord. 2013;11(3):157-162. Doi: https://doi.org/10.1089/met.2012.0151.
  40. Kanbay M., Segal M., Afsar B. et al. The role of uric acid in the pathogenesis of human cardiovascular disease. Heart. 2013;С. heartjnl-2012-302535. DOI:http://dx.doi.org/10.1136/heartjnl-2012-302535.
  41. Kaufman M. Uric acid in heart failure: a biomarker or therapeutic target? Heart Fail Rev. 2013;18(2):177-186. doi: 10.1007/s10741-012-9322-2.
  42. Johnson R.J., Nakagawa T., Jalal D. et al. Uric acid and chronic kidney disease: which is chasing which? Nephrol Dial Transplant. 2013;28(9):2221- 2228. Doi: https://doi.org/10.1093/ndt/gft029.
  43. Goicoechea M., de Vinuesa S.G., Verdalles U. et al. Effect of allopurinol in chronic kidney disease progression and cardiovascular risk. Clinical Journal of the American Society of Nephrology. 2010;5(8):С. 1388-1393. doi: 10.2215/CJN.01580210.
  44. Goicoechea M., Garcia de Vinuesa S., Verdalles U. et al. Allopurinol and Progression of CKD and Cardiovascular Events: Long-term Follow-up of a Randomized Clinical Trial. Am J Kidney Dis. 2015;65(4):543-549. doi: 10.1053/j.ajkd.2014.11.016.
  45. Mikhail A., Brown C., Williams J.A. et al. Renal association clinical practice guideline on Anaemia of Chronic Kidney Disease. BMC Nephrol. 2017;30:18(1):345. doi: 10.1186/s12882-017-0688-1.
  46. Муркамилов И.Т., Айтбаев К.А., Байсымакова Ф.К. и др. Факторы, способствующие прогрессированию гломерулонефритов и сердечно-сосудистых нарушений. Журнал здоровье и образование в XXI веке. 2017;19(8):32-39.
  47. Babitt J.L., Lin H. Y. Mechanisms of anemia in CKD. Journal of the American Society of Nephrology. 2012;С. ASN. 2011111078. Doi:10.1681/ ASN.2011111078.
  48. Delles C., Vanholder R. Chronic kidney disease. Clinical Science. 2017;131(3):225-226. doi: 10.1042/CS20160624.
  49. Neri L., Rocca Rey L.A., Lentine K.L. et al. Joint association of hyperuricemia and reduced GFR on cardiovascular morbidity: a historical cohort study based on laboratory and claims data from a national insurance provider. Am J Kidney Dis. 2011;58(3):398-408. DOI:https://doi.org/10.1053/j. ajkd.2011.04.025.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies