{"title":"[URATE AS A POTENTIAL RISK FACTOR OF CARDIOVASCULAR AND RENAL DISEASES].","authors":"M Butković","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>Although asymptomatic hyperuricemia is rather often in laboratory reports, it cannot be considered a disease. Despite the\nhigh prevalence of hyperuricemia in patients with arterial hypertension (AH), chronic kidney disease (CKD), cardiovascular\ndisease (CVD) or metabolic syndrome, hyperuricemia is not confirmed as a causative factor of these disorders. The aim is\nto point to the latest studies of the importance of urate as a possible cardiorenal risk factor. The literature published in 2015\nand 2016 was searched for the possible impact of urate level on the development of cardiorenal diseases. The PubMed,\nCochrane, Medline, and UpToDate databases were searched for the literature published between November 2009 and\nOctober 2016 using the following key words: urate, hyperuricemia, cardiovascular disease, and chronic kidney disease.\nCausative correlation of hyperuricemia is confirmed only in disorders where deposits of monosodium urate crystals are\npresent. Results of recent studies do not justify routine use of xanthine oxidase inhibitors in asymptomatic hyperuricemia.\nSome studies with small numbers of patients and short follow up report on endothelial function improvement on therapy\nwith xanthine oxidase inhibitors. Nonpharmacological intervention by changing unhealthy lifestyle is preferred. Treatment\nof asymptomatic hyperuricemia in CKD is still debated, and additional studies are necessary to demonstrate the benefit\nof lowering urate level in CKD. Family doctors (general practitioners) should be familiar with the recommended approach\nto patients with asymptomatic hyperuricemia. Evidence based medicine still does not recommend target determination\nof serum urate level for identifying CVD and CKD risk factors. Recent studies suggest the possible effect of uric acid in\ncardiorenal diseases and that treatment of asymptomatic hyperuricemia with xanthine oxidase inhibitors may also be\nuseful in CVD prevention. Additional studies are needed to prove this statement.</p>","PeriodicalId":35756,"journal":{"name":"Acta Medica Croatica","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Medica Croatica","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Although asymptomatic hyperuricemia is rather often in laboratory reports, it cannot be considered a disease. Despite the
high prevalence of hyperuricemia in patients with arterial hypertension (AH), chronic kidney disease (CKD), cardiovascular
disease (CVD) or metabolic syndrome, hyperuricemia is not confirmed as a causative factor of these disorders. The aim is
to point to the latest studies of the importance of urate as a possible cardiorenal risk factor. The literature published in 2015
and 2016 was searched for the possible impact of urate level on the development of cardiorenal diseases. The PubMed,
Cochrane, Medline, and UpToDate databases were searched for the literature published between November 2009 and
October 2016 using the following key words: urate, hyperuricemia, cardiovascular disease, and chronic kidney disease.
Causative correlation of hyperuricemia is confirmed only in disorders where deposits of monosodium urate crystals are
present. Results of recent studies do not justify routine use of xanthine oxidase inhibitors in asymptomatic hyperuricemia.
Some studies with small numbers of patients and short follow up report on endothelial function improvement on therapy
with xanthine oxidase inhibitors. Nonpharmacological intervention by changing unhealthy lifestyle is preferred. Treatment
of asymptomatic hyperuricemia in CKD is still debated, and additional studies are necessary to demonstrate the benefit
of lowering urate level in CKD. Family doctors (general practitioners) should be familiar with the recommended approach
to patients with asymptomatic hyperuricemia. Evidence based medicine still does not recommend target determination
of serum urate level for identifying CVD and CKD risk factors. Recent studies suggest the possible effect of uric acid in
cardiorenal diseases and that treatment of asymptomatic hyperuricemia with xanthine oxidase inhibitors may also be
useful in CVD prevention. Additional studies are needed to prove this statement.
期刊介绍:
ACTA MEDICA CROATICA publishes original contributions to medical sciences, that have not been previously published. All manuscripts should be written in English.