Serum Uric Acid Level and Endothelial Dysfunction in Patients with Nondiabetic Chronic Kidney Disease
Serum Uric Acid Level and Endothelial Dysfunction in Patients with Nondiabetic Chronic Kidney Disease
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DOI：
10.1159/000324847
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发表时间：
2011-01-01
影响因子：
4.2
通讯作者：
Johnson, Richard J.
中科院分区：
文献类型：
--
作者：
Kanbay, Mehmet;Yilmaz, Mahmut Ilker;Johnson, Richard J.
背景：血清尿酸水平升高与内皮功能障碍和炎症密切相关，这两种情况在慢性肾脏疾病（CKD）中都很常见。我们假设CKD患者的内皮功能障碍与尿酸水平相关。材料和方法：我们评估了486例新近诊断的CKD（3-5期）患者中的263例（男性48%，年龄52 - 12岁）血清尿酸水平与超声血流介导扩张（FMD）之间的关系。为了尽量减少混淆，233名患者被排除在外，因为他们是糖尿病患者，有心血管并发症或正在服用干扰血管功能的药物（肾素-血管紧张素系统阻滞剂，他汀类药物）。结果：血清尿酸水平在CKD的所有阶段均显著升高，且与肾小球滤过率（eGFR-MDRD）密切相关；口蹄疫与血清尿酸呈负相关（r = -0.49, p < 0.001）。在调整了年龄、性别、吸烟、低密度脂蛋白胆固醇、eGFR、高敏c反应蛋白、收缩压、蛋白尿和稳态模型评估指数后，血清尿酸与FMD的相关性仍然存在（β = -0.27, p < 0.001）。结论：血清尿酸升高是CKD患者内皮功能障碍的独立预测因子。巴塞尔S. Karger股份有限公司版权所有
Background: An elevated serum uric acid level is strongly associated with endothelial dysfunction and inflammation, both of which are common in chronic kidney disease (CKD). We hypothesized that endothelial dysfunction in subjects with CKD would correlate with uric acid levels. Materials and Methods: We evaluated the association between serum uric acid level and ultrasonographic flow-mediated dilatation (FMD) in 263 of 486 patients with recently diagnosed CKD (stage 3-5) (48% male, age 52 8 12 years). To minimize confounding, 233 patients were excluded because they were diabetic, had established cardiovascular complications or were taking drugs (renin-angiotensin system blockers, statins) interfering with vascular function. Results: Serum uric acid level was significantly increased in all stages of CKD and strongly correlated with estimated glomerular filtration rate (eGFR-MDRD); FMD was inversely associated with serum uric acid (r = -0.49, p < 0.001). The association of serum uric acid with FMD remained after adjustment for age, gender, smoking, LDL cholesterol, eGFR, high-sensitivity C-reactive protein, systolic blood pressure, proteinuria, and homeo static model assessment index (beta = -0.27, p < 0.001). Conclusion: Increased serum uric acid is an independent predictor of endothelial dysfunction in subjects with CKD. Copyright (C) 2011 S. Karger AG, Basel