Association between Serum Uric Acid Levels, Nutritional and Antioxidant Status in Patients on Hemodialysis

Domínguez-Zambrano, Etna; Pedraza‐Chaverrí, José; López-Santos, Ana Laura; Medina-Campos, Omar Noel; Cruz-Rivera, Cristino; Bueno-Hernández, Francisco; Espinosa-Cuevas, Ángeles

doi:10.3390/nu12092600

Cited by 15 publications

(11 citation statements)

References 46 publications

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“…Some limitations of this study are the short half-lives of TAC. Nevertheless, some studies report the measurement of this biomarker from serum samples [ 42 – 44 ]. Moreover, MDA is an end product of lipid peroxidation; thus, it is stable and has a long half-life.…”

Section: Discussionmentioning

confidence: 99%

Oxidative Stress Biomarkers and Their Association with Mortality among Patients Infected with SARS-CoV-2 in Mexico

Ávila-Nava

Pech-Aguilar

Lugo

et al. 2022

Oxidative Medicine and Cellular Longevity

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Background. Activation of the immune system response is associated with the generation of oxidative stress (OS). Several alterations are involved in OS, such as excessive production of reactive oxygen species (ROS) and decreased antioxidant activity, which together lead to an imbalance in redox status. The role of OS during SARS-CoV-2 infection is not fully understood. The aim of this study was to determine OS biomarkers and assess their usefulness as a predictor of mortality in COVID-19 patients. Methods. Baseline characteristics and serum samples were collected from hospitalized COVID-19 patients and compared with healthy controls. The serum OS biomarkers, including malondialdehyde (MDA) and total antioxidant capacity (TAC), were assessed by spectrophotometric and oxygen radical absorbance capacity (ORAC) methods, respectively. Results. A total of 152 individuals were analyzed (COVID-19 patients vs. healthy controls). Compared with healthy controls ( n = 76 ), patients infected with SARS-CoV-2 ( n = 76 ) presented higher levels of MDA ( p < 0.001 ) and decreased TAC ( p < 0.001 ). A total of 37 (49%) patients with COVID-19 died. The area under the receiver operating characteristic (ROC) curve (AUC) estimated that the combination of the OS biomarkers (MDA+TAC) ( AUC = 0.6394 , p = 0.037 ) was a significant predictor of mortality. A higher level of MDA was associated with mortality (HR, 1.05, 95% CI, 1.00–1.10, p = 0.045 ). Conclusion. This study concludes that OS is increased in patients with COVID-19 and is associated with mortality. To our knowledge, this is the first evidence of the expression of OS biomarkers and their association with mortality among the Mexican population.

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Section: Discussionmentioning

confidence: 99%

Oxidative Stress Biomarkers and Their Association with Mortality among Patients Infected with SARS-CoV-2 in Mexico

Ávila-Nava

Pech-Aguilar

Lugo

et al. 2022

Oxidative Medicine and Cellular Longevity

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“…Second, SUA has strong antioxidant properties, as 60% of the free radical scavenging ability of human plasma is derived from the role of SUA [ 9 ]. Domínguez [ 17 ] confirmed that patients on hemodialysis with hyperuricemia had higher antioxidant capacity and less oxidative damage, and they also had better nutritional status in general, mainly according to impedance vectors. When the SUA level is too low, its antioxidant capacity is weakened and oxidative stress is increased.…”

Section: Discussionmentioning

confidence: 99%

Correlation analysis of low-level serum uric acid and cardiovascular events in patients on peritoneal dialysis

Kuang

et al. 2021

Int Urol Nephrol

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Background The impact of serum uric acid (SUA) on development of cardiovascular disease (CVD) in patients undergoing peritoneal dialysis (PD) remains controversial, especially the impact of hypouricemia (HUA) on CVD. The aim of our study was to investigate the influence of low-level SUA on cardiovascular (CV) events in PD patients. Methods A retrospective cohort study was conducted.728 PD patients from February 1, 2010 to May 31, 2019 were enrolled. All demographic and laboratory data were collected at baseline and 6 months after PD treatment. The study cohort was divided into four groups according to SUA level (μmol/L) after 6 months of PD: Group1 (< 360), Group2 (360–420), Group3 (420–480), Group4 (≥ 480). The clinical characteristics of each group were analyzed. With Group2 as reference, logistic regression analysis was performed to investigate the correlation between SUA levels and risk of CV events in patients undergoing PD. Use Kaplan–Meier method to generate CV events risk graph. Results 728 patients were enrolled in this study, including 403 (55.4%) males and 325 (44.6%) females, with an average age of 48.66 ± 13.98 years; of which 158 (21.7%) patients developed CV events. Multivariate COX regression showed that after adjusting for multiple clinical factors, Group1 (HR = 1.92, 95% CI 1.17–3.15, P = 0.01), Group3 (HR = 1.89, 95% CI 1.13–3.15, P = 0.015), and Group4 (HR = 2.38, 95% CI 1.35–4.19, P = 0.003) are all independent risk factors for developing CV events. The Kaplan–Meier risk curve of CV events showed that the risk of CV events in the Group1, Group3 and Group4 were significantly higher (Log-Rank = 12.67; P = 0.005). Restricted cubic spline (RCS) showed that SUA level is non-linearly associated with the risk of CV events, showing an U -shaped curve ( =13.3 P = 0.01). Conclusions Our study suggested that patients with SUA level less than 360 μmol/L also exhibited the higher risk for developing CV events, an U-shaped association between SUA level and risk of CV events in patients undergoing PD. Both SUA levels below 360 μmol/L and above 420 μmol/L were found to be significant risk factors for developing CV events in patients undergoing long-term PD.

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“…Moreover, poor appetite was associated with an elevated level of inflammatory markers and poor outcomes in HD patients [53]. Furthermore, the benefit of UA could also result from its antioxidant properties [54, 55].…”

Section: Discussionmentioning

confidence: 99%

Serum Uric Acid and Mortality in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Zhang

Han

et al. 2021

Blood Purif

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Background: Existing studies suggested conflicting relationships between serum uric acid (SUA) and mortality in CKD patients. The present meta-analysis aimed to determine whether SUA can be a predictor for mortality in CKD cohorts. Method: A systematical search was conducted on PubMed, EMBASE, and The Cochrane Library to identify studies reporting the relationship between SUA level and all-cause and cardiovascular mortality in CKD populations. In addition, random-effects models were adopted to calculate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Results: On the whole, 29 studies were involved. In the present meta-analysis, patients exhibiting the maximum SUA level showed an association with a significantly higher risk for all-cause mortality (HR, 1.30; 95% CI, 1.06–1.59) compared with patients exhibiting the minimum SUA level. As revealed from the meta-analysis of 8 studies, low level of SUA was another predictor for all-cause mortality in patients with CKD (HR, 1.36; 95% CI, 1.20–1.54). No significant relationship was identified between SUA and cardiovascular mortality. Conclusions: Higher and lower SUA levels are both associated with significantly increased risk of all-cause mortality in patients with CKD. A appreciate dose of treatment of lowering SUA agents should be confirmed.

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Association between Serum Uric Acid Levels, Nutritional and Antioxidant Status in Patients on Hemodialysis

Cited by 15 publications

References 46 publications

Oxidative Stress Biomarkers and Their Association with Mortality among Patients Infected with SARS-CoV-2 in Mexico

Oxidative Stress Biomarkers and Their Association with Mortality among Patients Infected with SARS-CoV-2 in Mexico

Correlation analysis of low-level serum uric acid and cardiovascular events in patients on peritoneal dialysis

Serum Uric Acid and Mortality in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis

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