Hyperuricemia, Acute and Chronic Kidney Disease, Hypertension, and Cardiovascular Disease: Report of a Scientific Workshop Organized by the National Kidney Foundation.
Hyperuricemia, Acute and Chronic Kidney Disease, Hypertension, and Cardiovascular Disease: Report of a Scientific Workshop Organized by the National Kidney Foundation.
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DOI：
10.1053/j.ajkd.2017.12.009
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发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Chertow GM
中科院分区：
文献类型：
--
作者：
Johnson RJ;Bakris GL;Borghi C;Chonchol MB;Feldman D;Lanaspa MA;Merriman TR;Moe OW;Mount DB;Sanchez Lozada LG;Stahl E;Weiner DE;Chertow GM
尿酸盐是痛风、肾结石和肿瘤溶解综合征引起的急性肾损伤的原因，但其与肾脏疾病、心血管疾病和糖尿病的关系仍存在争议。2016年9月，国家肾脏基金会组织了一次科学研讨会，以审查目前的证据。细胞培养研究和动物模型表明，血清尿酸盐浓度升高可导致肾脏疾病、高血压和代谢综合征。流行病学证据也支持血清尿酸盐浓度升高是肾脏疾病、高血压和糖尿病发生的危险因素，但方法学的差异和肾功能微小变化对血清尿酸盐浓度的影响使结论不确定。孟德尔随机化研究一般不支持血清尿酸盐在肾脏疾病、高血压或糖尿病中的因果作用，尽管解释因非同质人群、未能考虑环境相互作用以及缺乏对遗传多态性如何影响尿酸盐相关生物学机制的理解而变得复杂。虽然一些小型临床试验表明，降尿酸治疗对肾功能，血压和胰岛素抵抗有益，但其他试验则是负面的，许多试验存在设计限制和功效不足。因此，尿酸是否在肾脏和心血管疾病中具有因果作用需要进一步研究。
Urate is a cause of gout, kidney stones, and acute kidney injury from tumor lysis syndrome, but its relationship to kidney disease, cardiovascular disease, and diabetes remains controversial. A scientific workshop organized by the National Kidney Foundation was held in September 2016 to review current evidence. Cell culture studies and animal models suggest that elevated serum urate concentrations can contribute to kidney disease, hypertension, and metabolic syndrome. Epidemiologic evidence also supports elevated serum urate concentrations as a risk factor for the development of kidney disease, hypertension, and diabetes, but differences in methodologies and inpacts on serum urate concentrations by even subtle changes in kidney function render conclusions uncertain. Mendelian randomization studies generally do not support a causal role of serum urate in kidney disease, hypertension, or diabetes, although interpretation is complicated by nonhomogeneous populations, a failure to consider environmental interactions, and a lack of understanding of how the genetic polymorphisms affect biological mechanisms related to urate. Although several small clinical trials suggest benefits of urate-lowering therapies on kidney function, blood pressure, and insulin resistance, others have been negative, with many trials having design limitations and insufficient power. Thus, whether uric acid has a causal role in kidney and cardiovascular diseases requires further study.
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DOI：
10.1161/hypertensionaha.116.08488
发表时间：
2017-02
期刊：
Hypertension (Dallas, Tex. : 1979)
影响因子：
--
作者：
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DOI：
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发表时间：
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期刊：
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影响因子：
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