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Mild hyperuricemia and subclinical renal damage in untreated primary hypertension.
Viazzi, Francesca; Leoncini, Giovanna; Ratto, Elena; Falqui, Valeria; Parodi, Angelica; Conti, Novella; Derchi, Lorenzo E; Tomolillo, Cinzia; Deferrari, Giacomo; Pontremoli, Roberto.
Afiliación
  • Viazzi F; Department of Internal Medicine and Cardio-Nephrology, Azienda Universitaria Ospedale San Martino, University of Genoa, Genoa, Italy.
Am J Hypertens ; 20(12): 1276-82, 2007 Dec.
Article en En | MEDLINE | ID: mdl-18047917
BACKGROUND: Subclinical renal damage and hyperuricemia are not uncommon in patients with primary hypertension. Whether mild hyperuricemia reflects a subclinical impairment of renal function or contributes to its development is currently debated. We investigated the relationship between serum uric-acid levels and the occurrence of early signs of kidney damage. METHODS: Four hundred eighteen patients with primary hypertension were studied. Albuminuria was measured as the albumin-to-creatinine ratio, and creatinine clearance was estimated by the formula of Cockcroft and Gault. Interlobar resistive index and renal abnormalities, ie, the renal volume-to-resistive index ratio, were evaluated by renal Doppler and ultrasound. RESULTS: Uric acid was directly related to resistive index (P = .007) in women and to albuminuria (P = .04) in men, and was inversely related to the renal volume-to-resistive index ratio in both men (P = .005) and women (P = .02). Patients with uric-acid levels above the median showed a higher prevalence of microalbuminuria (14% v 7%, P = .012) and of renal abnormalities (41% v 33%, P = .007). Moreover, when creatinine clearance was taken as a covariate, patients with increased uric-acid levels showed higher albuminuria and resistive indices, and a lower renal volume-to-resistive index ratio. Even after adjustment for several risk factors, each standard deviation increase in serum uric acid entailed a 69% higher risk of microalbuminuria, and a 39% greater risk of ultrasound detectable renal abnormalities. CONCLUSIONS: Mild hyperuricemia is associated with early signs of renal damage, ie, microalbuminuria and ultrasound-detectable abnormalities, regardless of the glomerular filtration rate in primary hypertension.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hiperuricemia / Hipertensión / Enfermedades Renales Tipo de estudio: Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Hypertens Asunto de la revista: ANGIOLOGIA Año: 2007 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hiperuricemia / Hipertensión / Enfermedades Renales Tipo de estudio: Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Hypertens Asunto de la revista: ANGIOLOGIA Año: 2007 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos