tailieunhanh - Serum uric acid and acute kidney injury: A mini review

Acute kidney injury causes great morbidity and mortality in both the community and hospital settings. Understanding the etiological factors and the pathophysiological principles resulting in acute kidney injury is essential in prompting appropriate therapies. Recently hyperuricemia has been recognized as a potentially modifiable risk factor for acute kidney injury, including that associated with cardiovascular surgery, radiocontrast administration, rhabdomyolysis, and associated with heat stress. This review discussed the evidence that repeated episodes of acute kidney injury from heat stress and dehydration may also underlie the pathogenesis of the chronic kidney disease epidemic that is occurring in Central America (Mesoamerican nephropathy). Potential mechanisms for how uric acid might contribute to acute kidney injury are also discussed, including systemic effects on renal microvasculature and hemodynamics, and local crystalline and noncrystalline effects on the renal tubules. Pilot clinical trials also show potential benefits of lowering uric acid on acute kidney injury associated with a variety of insults. In summary, there is mounting evidence that hyperuricemia may have a significant role in the development of acute kidney injury. Prospective, placebo controlled, randomized trials are needed to determine the potential benefit of uric acid lowering therapy on kidney and cardio-metabolic diseases. | Journal of Advanced Research 8 2017 529-536 Contents lists available at ScienceDirect Journal of Advanced Research journal homepage locate jare Mini Review Serum uric acid and acute kidney injury A mini review Kai Hahna Mehmet Kanbayb Miguel A. Lanaspac Richard J. Johnsonc A. Ahsan Ejazd a Center for Nephrology Dialysis and Hypertension Dortmund 69120 Germany b Department of Medicine Division of Nephrology Koc University School of Medicine Istanbul 34010 Turkey c Division of Renal Diseases and Hypertension University of Colorado Denver 80045 USA d Division of Nephrology Hypertension and Transplantation University of Florida Gainesville FL 32610 USA CrossMark GRAPHICAL ABSTRACT ARTICLE INFO ABSTRACT Article history Received 17 May 2016 Revised 17 September 2016 Accepted 18 September 2016 Available online 24 September 2016 Keywords Uric acid Hyperuricemia Chronic kidney disease Acute kidney injury Contrast nephropathy Heat stress nephropathy Acute kidney injury causes great morbidity and mortality in both the community and hospital settings. Understanding the etiological factors and the pathophysiological principles resulting in acute kidney injury is essential in prompting appropriate therapies. Recently hyperuricemia has been recognized as a potentially modifiable risk factor for acute kidney injury including that associated with cardiovascular surgery radiocontrast administration rhabdomyolysis and associated with heat stress. This review discussed the evidence that repeated episodes of acute kidney injury from heat stress and dehydration may also underlie the pathogenesis of the chronic kidney disease epidemic that is occurring in Central America Mesoamerican nephropathy . Potential mechanisms for how uric acid might contribute to acute kidney injury are also discussed including systemic effects on renal microvasculature and hemodynamics and local crystalline and noncrystalline effects on the renal tubules. Pilot clinical trials also show .

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• Heat stress nephropathy
• Serum uric acid
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