Association of serum uric acid change with mortality, renal function and diuretic dose administered in treatment of acute heart failure

Zhou, Haobin; Xu, Tianyu; Liu, S.-R.; Bai, Yiping; Huang, Xiaojie; Zhan, Qimin; Zeng, Qingchun; Xu, Dong-ping

doi:10.1016/j.numecd.2019.01.001

Cited by 14 publications

(18 citation statements)

References 36 publications

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“…Hyperuricemia is associated with many chronic diseases. For example, hypertension [2,3] , diabetes [4,5] and cardiovascular disease [6][7][8] interact with hyperuricemia. The relationship between uric acid and renal function has received widespread attention in recent years.…”

Section: Discussionmentioning

confidence: 99%

“…Hyperuricemia (HUA) is a disease with a high incidence of 13.3% in China in the years from 2000 to 2014 [1] . Hyperuricemia is an independent risk factor for hypertension [2,3] , diabetes [4,5] , cardiovascular disease [6][7][8] and renal disease [9][10][11] , which are serious hazards. The main treatment for hyperuricemia is using uric acid-lowering agents.…”

Section: Introductionmentioning

confidence: 99%

“…However, other RCT studies have not found a relationship between uric acid-lowering agents and chronic kidney disease (CKD) [24][25][26][27][28][29] , indicating that there may be other mechanism besides uric acid-lowering agents to improve renal disease. Zhou, H. B, et al [8] found that in patients with acute heart failure, worse renal function was significantly more common in patients experiencing increased uric acid (UA). Takayuki Tsuji, et al [30] reported a retrospective observational study and found that serum uric acid reduction might have beneficial effects on CKD progression in CKD patients with hyperuricemia.…”

Section: Introductionmentioning

confidence: 99%

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Peer Review #1 of "Association between uric acid lowering and renal function progression: a longitudinal study (v0.1)"

2021

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Background : This study aimed to explore the association between uric acid lowering and renal function. Materials and Methods:We conducted a population-based cohort study with 1534 subjects for 4 years from 2012 to 2016. The population was divided into four groups according to the interquartile range of changes in serum uric acid with quartile 1 representing lower quarter . Renal function decline was defined as eGFR decreased more than 10% from baseline in 2016. Renal function improvement was defined as eGFR increased more than 10% from baseline in 2016. Cox regression analysis was used to calculate the hazard ratio (HR) and 95% confidence interval (CI).Results: In the adjusted Cox regression models, compared to quartile 4, quartile 1 (HR = 0.64 , 95% CI: 0.49 -0.85 ) , quartile 2 (HR = 0.65, 95% CI: 0.50 -0.84 ) and quartile 3 ( HR = 0.75 , 95% CI: 0.58 -0.96) have reduced risk of renal function decline . An increasing hazard ratio of renal function improvement was shown in quartile 1 (HR = 2.27, 95% CI: 1.45 -3.57 ) and quartile 2 (HR =1.78 , 95% CI: 1.17 -2.69 ) compared with quartile 4.Conclusions: Uric acid lowering is associated with changes in renal function. The management of serum uric acid should receive attention in clinical practice and is supposed to be part of the treatment of chronic kidney disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Peer Review #1 of "Association between uric acid lowering and renal function progression: a longitudinal study (v0.1)"

2021

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“…While a decline in LVEF may represent a late marker of cardiotoxicity [ 16 ], a normal LVEF does not exclude the presence of early HF or HF with preserved LVEF (HFpEF). Given that HFpEF constitutes between 22 and 73% of HF patients in the general population (HFpEF), a significant number of patients might have been excluded from analysis [ 17 – 19 ]. Recently, the importance of brain natriuretic peptide (BNP) or N-terminal probrain natriuretic peptide (NT-proBNP) as a biomarker for the diagnosis and prognostic evaluation of HF has been emphasized in European, U.S., and Chinese guidelines [ 17 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Patients with Different N-Terminal Probrain Natriuretic Peptide Levels after Hematopoietic Stem Cell Transplantation

Zhou

et al. 2020

Disease Markers

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Heart failure (HF) is not uncommon among patients with hematologic malignancies (HM) undergoing hematopoietic stem cell transplantation (HSCT) and is associated with an increased mortality. Among HSCT patients without signs or symptoms of HF, groups with elevated and normal N-terminal probrain natriuretic peptide (NT-proBNP) levels have been poorly characterized in previous literature. Herein, we reviewed consecutive admissions for HM undergoing HSCT ( n = 301 ). Based on NT-proBNP levels and clinical signs or symptoms of HF at follow-up (one month after HSCT), patients were grouped into ENPH (elevated N T ‐ proBNP > 125 pg / mL , presence of HF symptoms or signs), ENAH (elevated N T ‐ proBNP > 125 pg / mL , absence of HF symptoms or signs), and NN (normal N T ‐ proBNP < 125 pg / mL ). ENPH, ENAH, and NN were observed in 22.9%, 54.5%, and 22.6% of patients, respectively. ENPH patients had a significantly higher baseline NT-proBNP level, followed by the ENAH and NN groups, respectively ( P < 0.001 ). Frequencies of HLA partially matched related donors, stem cell source (bone marrow+peripheral blood), and utilization of graft-versus-host disease prophylaxis regimens (ciclosporin+methotrexate+antithymocyte globulin±mycophenolate mofetil) were also the highest in the ENPH group, followed by ENAH and NN groups, respectively (all P < 0.05 ). Uric acid and hemoglobin levels, transplant type, and cyclophosphamide-based conditioning regimens utilized were similar between the ENAH and ENPH groups. We found that ENPH and ENAH are commonly observed in HM hospitalized for HSCT. Serum NT-proBNP levels may allow for earlier identification of HSCT patients at high risk of developing cardiac dysfunction.

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“…Хотя ассоциация ГУ с ССЗ давно известна [9], возможность применения для лечения таких пациентов препаратов, снижающих уровень мочевой кислоты (МК), стала рассматриваться только в последние годы, после появления крупных наблюдательных исследований, доказывающих, что ГУ независимо от других факторов риска коррелирует с развитием как ССЗ в целом, так и непосредственно с СН [10][11][12][13].…”

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Urate-lowering therapy for heart failure

Желябина¹,

Елисеев²

2019

Sovremennaâ revmatologiâ

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Сердечная недостаточность (СН) связана с высоким риском смерти и значительными финансовыми потерями, обусловленными в том числе необходимостью частой госпитализации в отделения неотложной помощи и палаты интенсивной терапии. СН характеризуется выраженным, прогрессирующим ухудшением качества жизни в результате снижения трудоспособности и толерантности к минимальной физической нагрузке [1-2]. Это одна из основных проблем общественного здравоохранения развитых стран: ежегодно СН диагностируется более чем у 550 тыс. человек, она выявлена у 5,8 млн жителей США. По данным ВОЗ, в мире насчитывается не менее 23 млн больных СН, более 1 млн из них госпитализируют в течение календарного года. СН является непосредственной причиной более 7% всех сердечно-сосудистых смертей [3, 4]. В отличие от других форм сердечно-сосудистых заболеваний (ССЗ), в частности ишемической болезни сердца (ИБС) и острого нарушения мозгового кровообращения, в лечении которых в последние десятилетия достигнуты серьезные успехи, распространенность, заболеваемость СН и смертность от нее в последние несколько десятилетий не только не снижаются, но и возрастают, и прогноз остается крайне неблагоприятным [5, 6]. Показатели смертности при СН столь высоки, что превосходят таковые при онкологических заболеваниях: более 40% пациентов умирают в течение года после первой госпитализации [7]. Среди факторов риска, непосредственно влияющих на развитие, тяжесть течения, прогрессирование и исходы СН, выделяют традиционные, необходимость коррекции которых не вызывает сомнений: артериальная гипертензия, нарушения сердечного ритма, кардиомиопатии, сахарный диабет (СД), гиперхолестеринемия и дислипидемия, курение, злоупотребление алкоголем, а также нетрадиционные, влияние которых на риск развития ССЗ и их исходы стало активно обсуждаться относительно недавно: хроническое воспаление, гиперурикемия (ГУ), дефицит витамина D. Изучение фармакологических методов коррекции нетрадиционных факторов риска может стать перспективным направлением терапии СН. Одной из мишеней такой терапии пред

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Association of serum uric acid change with mortality, renal function and diuretic dose administered in treatment of acute heart failure

Cited by 14 publications

References 36 publications

Peer Review #1 of "Association between uric acid lowering and renal function progression: a longitudinal study (v0.1)"

Peer Review #1 of "Association between uric acid lowering and renal function progression: a longitudinal study (v0.1)"

Clinical Characteristics of Patients with Different N-Terminal Probrain Natriuretic Peptide Levels after Hematopoietic Stem Cell Transplantation

Urate-lowering therapy for heart failure

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