Uric Acid as a Marker for Renal Dysfunction in Hypertensive Women on Diuretic and Nondiuretic Therapy

Uric Acid as a Marker for Renal Dysfunction in Hypertensive Women on Diuretic and Nondiuretic Therapy

Author Borges, Rodolfo. L. Autor UNIFESP Google Scholar
Hirota, Andrea H. Autor UNIFESP Google Scholar
Quinto, Beata M. Autor UNIFESP Google Scholar
Ribeiro, Artur B. Autor UNIFESP Google Scholar
Zanella, Maria T. Autor UNIFESP Google Scholar
Batista, Marcelo C. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Hyperuricemia is a common finding in hypertensive patients, especially among those who are on diuretic therapy. However, its clinical relevance regarding cardiovascular and chronic kidney disease (CKD) has not clearly been established. the authors assessed whether, in a population of 385 hypertensive women categorized according to diuretic therapy, the stratification in quartiles by uric acid levels would identify a gradient of changes in renal function and in risk factors for cardiovascular disease. the following were evaluated: serum uric acid, glycemia, total and fractional cholesterol, triglycerides, apolipoprotein (Apo) B, Apo A-I, and C-reactive protein. Renal function was assessed by serum creatinine, albuminuria, and estimated glomerular filtration rate (eGFR) by the Modification of Diet in Renal Disease equation, whereas cardiovascular risk was estimated through the Framingham score. A total of 246 women were on diuretic therapy; 139 were taking other antihypertensive medications. There was a reduction in eGFR parallel to the increase in uric acid levels, regardless of diuretic use and without a concomitant increase in albuminuria. in both groups, higher uric acid levels translated into an increase in metabolic syndrome components, in markers of insulin resistance, triglyceride/high-density lipoprotein levels, and Apo B/Apo A-I ratios, as well as in Framingham scores. Hyperuricemia was associated with an increase in inflammatory markers only in patients on diuretic therapy. in a binary logistic regression, hyperuricemia (uric acid > 6.0 mg/dL) was independently associated with CKD (eGFR < 60 mL/min/1.73 m(2)) (odds ratio, 2.63; 95% confidence interval, 1.61-4.3; P <.001). in hypertensive women, the presence of hyperuricemia indicated a substantial degree of kidney dysfunction as well as a greater cardiovascular risk profile.
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Date 2009-05-01
Published in Journal of Clinical Hypertension. Malden: Wiley-Blackwell Publishing, Inc, v. 11, n. 5, p. 253-259, 2009.
ISSN 1524-6175 (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 253-259
Origin http://dx.doi.org/10.1111/j.1751-7176.2009.00101.x
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000266336200002
URI http://repositorio.unifesp.br/handle/11600/31477

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