Modern concepts of the role of asymptomatic hyperuricemia in the formation of chronic kidney disease and cardiovascular risk

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Abstract

Asymptomatic hyperuricemia is a term traditionally applied to conditions in which serum urate concentrations are elevated, but there are no symptoms or signs of diseases associated with precipitation of uric acid crystals, such as gout or uric acid kidney disease. According to a number of studies, hyperuricemia is associated with other disorders that are not directly related to crystal deposition (including chronic kidney disease – CKD, arterial hypertension, cardiovascular, and neurological diseases). The purpose of this review was to analyze modern literature on modern concepts of the etiology, pathogenesis, diagnostic criteria for asymptomatic hyperuricemia and its role in the formation of renal dysfunction, cardiovascular and metabolic disorders.

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About the authors

Anna V. Dudnikova

Clinic of the Kuban State Medical University

Author for correspondence.
Email: avdudnikova@yandex.ru
ORCID iD: 0000-0003-2601-7831
SPIN-code: 7480-1992

Cand.Sci. (Med.), Cardiologist at the Clinic 

Russian Federation, Krasnodar

Ruslan A. Mekhrabov

Kuban State Medical University

Email: rus.mekhrabrv@mail.ru

6th-year Student at the Faculty of Medicine

Russian Federation, Krasnodar

Anastasia R. Alieva

Kuban State Medical University

Email: ananastasiya00@mail.ru

6th-year Student at the Faculty of Medicine

Russian Federation, Krasnodar

Zamira A. Gish

Clinic of the Kuban State Medical University

Email: sofiaalieva0501@mail.ru

6th-year Student at the Faculty of Medicine

Russian Federation, Krasnodar

Andrey A. Leontyev

Kuban State Medical University

Email: aaleontyev00@icloud.com

6th-year Student at the Faculty of Medicine

Russian Federation, Krasnodar

Daria A. Rasskazova

Kuban State Medical University

Email: d_rasskazova@mail.ru

6th-year Student at the Faculty of Medicine

Russian Federation, Krasnodar

References

  1. Zhu Y., Pandya B.J., Choi H.K. Prevalence of gout and hyperuricemia in the US general population: The National Health and Nutrition Examination Survey 2007-2008. Arthr. Rheum. 2011;63:3136–41. doi: 10.1002/art.30520.
  2. Perez-Ruiz F., Marimon E., Chinchilla S.P. Hyperuricaemia with deposition: Latest evidence and therapeutic approach. Ther. Adv. Musculoskelet. Dis. 2015;7:225–33. doi: 10.1177/1759720X15599734.
  3. Dalbeth N., House M.E., Aati O., et al. Urate crystal deposition in asymptomatic hyperuricaemia and symptomatic gout: A dual energy CT study. Ann. Rheum. Dis. 2015;74:908–11. doi: 10.1136/annrheumdis-2014-206397. [PubMed] [CrossRef] [Google Scholar].
  4. Campion E.W., Glynn R.J., DeLabry L.O. Asymptomatic hyperuricemia. Risks and consequences in the Normative Aging Study. Am. J. Med. 1987;82:421.
  5. Hall A.P., Barry P.E., Dawber T.R., McNamara P.M. Epidemiology of gout and hyperuricemia. A long-term population study. Am. J. Med. 1967;42:27.
  6. Lin K.C., Lin H.Y., Chou P. Community based epidemiological study on hyperuricemia and gout in Kin-Hu, Kinmen. J. Rheum. 2000;27:1045.
  7. Zhu Y., Pandya B.J., Choi H.K. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey, 2007–2008. Arthr. Rheum 2011;63:3136.
  8. 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):153–59. https://doi.org/10.20996/1819-6446-2014-10-2- 153-159
  9. Mumford S.L., Dasharathy S.S., Pollack A.Z. Serum uric acid in relation to endogenous reproductive hormones during the menstrual cycle: findings from the BioCycle study. Hum Reprod. 2013;28(7):1853.
  10. Hu J., Xu W., Yang H., Mu L. Uric acid participating in female reproductive disorders: a review. Reprod. Biol. Endocrinol. 2021;19(1):65. doi: 10.1186/s12958-021-00748-7.
  11. Hak A.E., Choi H.K. Menopause, postmenopausal hormone use and serum uric acid levels in US women – the Third National Health and Nutrition Examination Survey. Arthr. Res. Ther. 2008;10(5):R116.
  12. Cota E., Souza L.A., D'Angelo G.C.O., et al. Uric acid level in climacteric women and its association with clinical and metabolic parameters. Sci. Rep. 2023;13(1):8475. doi: 10.1038/s41598-023-35287-1.
  13. Dong Y., Wang Z., Wang S., et al. Gender-Specific and U-Shaped Relationship Between Serum Uric Acid and All-Cause Mortality Among Chinese Older Adults: A National Population-Based Longitudinal Study. Int. J. Public. Health. 2023;68:1605934. doi: 10.3389/ijph.2023.1605934.
  14. El Ridi R., Tallima H. Physiological functions and pathogenic potential of uric acid: A review. J. Adv. Res. 2017;8:487–93. doi: 10.1016/j.jare.2017.03.003.
  15. Yanai H., Adachi H., Hakoshima M., Katsuyama H. Molecular Biological and Clinical Understanding of the Pathophysiology and Treatments of Hyperuricemia and Its Association with Metabolic Syndrome, Cardiovascular Diseases and Chronic Kidney Disease. Int. J. Mol. Sci. 2021;22(17):9221. doi: 10.3390/ijms22179221.
  16. Li R., Yu K., Li C. Dietary factors and risk of gout and hyperuricemia: A meta-analysis and systematic review. Asia. Pac. J. Clin. Nutr. 2018;27: 1344–56.
  17. 37. Jamnik J., Rehman S., Blanco Mejia S., et al. Fructose intake and risk of gout and hyperuricemia: A systematic review and meta-analysis of prospective cohort studies. BMJ. Open. 2016;6:e013191. doi: 10.1136/bmjopen-2016-013191.
  18. Xu L., Shi Y., Zhuang S., Liu N. Recent advances on uric acid transporters. Oncotarget. 2017;8:100852–62. doi: 10.18632/oncotarget.20135.
  19. Li R., Yu K., Li C. Dietary factors and risk of gout and hyperuricemia: A meta-analysis and systematic review. Asia. Pac. J. Clin. Nutr. 2018;27:1344–56.
  20. Sivera F., Andres M., Dalbeth N. A glance into the future of gout. Ther. Adv. Musculoskelet. Dis. 2022;14:1759720X221114098. doi: 10.1177/1759720X221114098.
  21. Шабалин В.В., Гринштейн Ю.И., Руф Р.Р., Самсонов Н.С. Бессимптомная гиперурикемия: очевидное, спорное, гипотетическое. Профилактическая медицина. 2023;26(7):103–9.
  22. Eckardt K.U., Alper S.L., Antignac C., et al. Kidney Disease: Improving Global Outcomes. Autosomal dominant tubulointerstitial kidney disease: diagnosis, classification, and management – A KDIGO consensus report. Kidney Int. 2015;88(4):676–83. doi: 10.1038/ki.2015.28.
  23. Баранов А.А., Намазова-Баранова Л.С., Маргиева Т.В. и др. Петлевые тубулопатии: синдром Барттера. Педиатрическая фармакология. 2019;16(2):85–90. doi: 10.15690/pf.v16i2.2004.
  24. Tian X., Chen S., Wang P., et al. Temporal relationship between hyperuricemia and hypertension and its impact on future risk of cardiovascular disease. Eur. J. Intern. Med. 2023;111:82–9. doi: 10.1016/j.ejim.2023.02.023.
  25. Richette P., Perez-Ruiz F., Doherty M., et al. Improving cardiovascular and renal outcomes in gout: what should we target? Nat. Rev. Rheum. 2014;10:654–61. doi: 10.1038/nrrheum.2014.12.
  26. Ubhadiya T.J., Dubey N., Sojitra M.H., et al. Exploring the Effects of Elevated Serum Uric Acid Levels on Hypertension: A Scoping Review of Hyperuricemia. Cureus. 2023;15(8):e43361. doi: 10.7759/cureus.43361.
  27. Cabău G., Gaal O., Badii M., et al. HINT-consortium; Pamfil C, Popp R.A., Netea M.G., Rednic S., Crișan T.O., Joosten LAB. Hyperuricemia remodels the serum proteome toward a higher inflammatory state. Science. 2023;26(10):107909. doi: 10.1016/j.isci.2023.107909.
  28. Nashar K., Fried L.F. Hyperuricemia and the progression of chronic kidney disease: is uric acid a marker or an independent risk factor? Adv. Chronic. Kidney Dis. 2012;19:386–91. doi: 10.1053/j.ackd.2012.05.004.
  29. Moe O.W. Posing the question again: does chronic uric acid nephropathy exist? J. Am. Soc. Nephrol. 2010;21:395–97. doi: 10.1681/ASN.20081011158.
  30. Sato Y., Feig D.I., Stack A.G., et al. The case for uric acid-lowering treatment in patients with hyperuricaemia and CKD. Nat. Rev. Nephrol. 2019;15:767–75. doi: 10.1038/s41581-019-0174-z.
  31. Cheng D., Du R., Wu X.Y., et al. Serum Uric Acid is Associated with the Predicted Risk of Prevalent Cardiovascular Disease in a Community-dwelling Population without Diabetes. Biomed. Environ. Sci. 2018;31:106–14. doi: 10.3967/bes2018.013.
  32. Zhu Y., Pandya B.J., Choi H.K. Comorbidities of gout and hyperuricemia in the US general population: NHANES 2007-2008. Am. J. Med. 2012;125(7):679–87.e1. doi: 10.1016/j.amjmed.2011.09.033.
  33. Dang W., Xu X., Luo D., et al. Analysis of Risk Factors for Changes in the Renal Two-Dimensional Image in Gout Patients. Int. J. Gen. Med. 2021;14:6367–78. doi: 10.2147/IJGM.S336220.
  34. Tang H., Zhao Y., Tan C., Liu Y. Significance of Serum Markers and Urinary Microalbumin in the Diagnosis of Early Renal Damage in Patients with Gout. Clin. Lab. 2021;67(5). doi: 10.7754/Clin.Lab.2020.200722. [PMID: 33978372].
  35. Borghi C., Rosei E.A., Bardin T., et al. Serum uric acid and the risk of cardiovascular and renal disease. J. Hypertens. 2015;33:1729–41. doi: 10.1097/HJH.0000000000000701.
  36. Curhan G.C., Taylor E.N. 24-h uric acid excretion and the risk of kidney stones. Kidney Int. 2008;73(4):489–96. doi: 10.1038/sj.ki.5002708.
  37. Gaita L., Timar R., Lupascu N., et al. The Impact Of Hyperuricemia On Cardiometabolic Risk Factors In Patients With Diabetes Mellitus: A Cross-Sectional Study. Diab. Metab. Syndr. Obes. 2019;12:2003–10. doi: 10.2147/DMSO.S222570.
  38. De Cosmo S., Viazzi F., Pacilli A., et al. Serum Uric Acid and Risk of CKD in Type 2 Diabetes. Clin. J. Am. Soc. Nephrol. 2015;10:1921–29. doi: 10.2215/CJN.03140315.
  39. Feig D.I., Madero M., Jalal D.I., et al. Uric acid and the origins of hypertension. J. Pediatr. 2013;162:896–902. doi: 10.1016/j.jpeds.2012.12.078.
  40. Zeng W.T., Sun X.T., Tang K., et al. Risk of thromboembolic events in atrial fibrillation with chronic kidney disease. Stroke. 2015;46:157–63. 10.1161/STROKEAHA.114.006881.
  41. Singh J.A., Yu S. Allopurinol and the risk of atrial fibrillation in the elderly: a study using Medicare data. Ann. Rheum. Dis. 2017;76:72–8. doi: 10.1136/annrheumdis-2015-209008. Verdecchia P., Schillaci G., Reboldi G., et al. Relation between serum uric acid and risk of cardiovascular disease in essential hypertension. The PIUMA study Hypertension. 2000;36:1072–78. doi: 10.1161/01.HYP.36.6.1072.
  42. Kamei K., Konta T., Hirayama A. Associations between serum uric acid levels and the incidence of nonfatal stroke: a nationwide community-based cohort study. Clin. Exp. Nephrol. 2017;21:497–503. doi: 10.1007/s10157-016-1311-7.
  43. Patetsios P., Song M., Shutze W.P., et al. Identification of uric acid and xanthine oxidase in atherosclerotic plaque. Am. J. Cardiol. 2001;88:188–91. doi: 10.1016/S0002-9149(01)01621-6.
  44. Park J.J., Roudier M.P., Soman D., et al. Prevalence of birefringent crystals in cardiac and prostatic tissues, an observational study. BMJ. Open. 2014;4:e005308. 1Doi: 0.1136/bmjopen-2014-005308.
  45. Toncev G. Therapeutic value of serum uric acid levels increasing in the treatment of multiple sclerosis therapeutic value of serum uric acid levels increasing in the treatment of multiple sclerosis. Vojnosanit. Pregl. 2006;63:879–82. doi: 10.2298/VSP0610879T.
  46. Markowitz C.E. The treatment of multiple sclerosis with inosine. J. Altern. Complement Med. 2009;15:619–25. doi: 10.1089/acm.2009.0104.

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