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Hypertension-associated asymptomatic hyperuricaemia in the adolescents


Authors: I. Koborová 1;  R. Kollárová 1;  Ľ. Podracká 2;  M. Gajdoš 3;  K. Šebeková 1
Authors‘ workplace: Ústav molekulárnej biomedicíny, Lekárska fakulta, Univerzita Komenského, Bratislava prednosta doc. MUDr. Ing. RNDr. P. Celec, PhD., MPH 1;  Klinika detí a dorastu, Lekárska fakulta, Univerzita Pavla Jozefa Šafárika, Košice prednostka prof. MUDr. Ľ. Podracká, PhD. 2;  Oddelenie klinickej a experimentálnej farmakoterapie Ústavu farmakológie, klinickej a experimentálnej farmakológie, Lekárska fakulta, Slovenská zdravotnícka univerzita, Bratislava vedúci doc. MUDr. M. Gajdoš, CSc. 3
Published in: Čes-slov Pediat 2014; 69 (3): 168-177.
Category: Review

Overview

Herein we summarize the current knowledge on the relationship between uric acid and hypertension in the adolescents. The role of uric acid as biologically active final metabolite of purine degradation pathway in humans is discussed in relation to human evolution, as well as from the pathophysiological point of view. Results of experimental, epidemiological and interventional studies suggesting causal relationship between hyperuricaemia and hypertension are presented. It is summarized that our current knowledge is insufficient to conclude whether hyperuricaemia is causally related to hypertension in the adolescents, or it merely represents a biomarker of increased risk of cardiovascular diseases or mortality. Due to lacking evidence no guidelines exist whether or not, or how, to treat hypertension associated asymptomatic hyperuricaemia. Randomized controlled prospective clinical trials are needed to confirm the potential benefits of lowering hyperuricaemia on progression of hypertension, end-organ damage, or the incidence of cardiovascular diseases.

Key words:
uric acid, purines, adolescents, hypertension, fructose, allopurinol, xantine oxidase inhibitors


Sources

1. Oda M, Satta Y, Takenaka O, et al. Loss of urate oxidase activity in hominoids and its evolutionary implications. Mol Biol Evol 2002; 19: 640–653.

2. Schlesinger N. Dietary factors and hyperuricaemia. Curr Pharma Des 2005; 11: 4133–4138.

3. Yamamoto T, Moriwaki Y, Takahashi S, et al. Effect of lactate infusion on renal transport of purine bases and oxypurinol. Nephron 1993; 65: 73–76.

4. van den Berghe G, Bronfman M, Vanneste R, et al. The mechanism of adenosine triphosphate depletion in the liver after a load of fructose. A kinetic study of liver adenylate deaminase. Biochem J 1977; 162: 601–609.

5. Teff KL, Elliott SS, Tschop M, et al. Dietary fructose reduces circulating insulin and leptin, attenuates postprandial suppression of ghrelin, and increases triglycerides in women. J Clin Endocrinol Metab 2004; 89: 2963–2972.

6. Lane MD, Cha SH. Effect of glucose and fructose on food intake via malonyl-CoA signaling in the brain. Biochem Biophys Res Commun 2009; 382: 1–5.

7. Johnston RD, Stephenson MC, Crossland H, et al. No difference between high-fructose and high-glucose diets on liver triacylglycerol or biochemistry in healthy overweight men. Gastroenterology 2013; 145: 1016-NIL_175.

8. Johnson RJ, Nakagawa T, Gabriela Sanchez-Lozada L, et al. Sugar, uric acid, and the etiology of diabetes and obesity. Diabetes 2013; 62: 3307–3315.

9. Reyes AJ. The increase in serum uric acid concentration caused by diuretics might be beneficial in heart failure. Eur J Heart Fail 2005; 7: 461–467.

10. Koettgen A, Albrecht E, Teumer A, et al. Genome-wide association analyses identify 18 new loci associated with serum urate concentrations. Nature Genetics 2013; 45: 145–154.

11. Masseoud D, Rott K, Liu-Bryan R, et al. Overview of hyperuricaemia and gout. Curr Pharm Des 2005; 11: 4117–4124.

12. Johnson RJ, Nakagawa T, Jalal D, et al. Uric acid and chronic kidney disease: which is chasing which? Nephrol Dial Transplant 2013; 28: 2221–2228.

13. Bellomo G. Uric acid and chronic kidney disease: A time to act? World J Nephrol 2013; 2: 17–25.

14. Bluestone R, Kippen I, Klinenberg JR. Effect of drugs on urate binding to plasma proteins. Br Med J 1969; 4: 590–593.

15. Kutzing MK, Firestein BL. Altered uric acid levels and disease states. J Pharmacol Exp Ther 2008; 324: 1–7.

16. Alvarez-Lario B, Macarron-Vicente J. Uric acid and evolution. Rheumatology 2010; 49: 2010–2015.

17. Johnson RJ, Titte S, Cade JR, et al. Uric acid, evolution and primitive cultures. Semin Nephrol 2005; 25: 3–8.

18. Watanabe S, Kang DH, Feng LL, et al. Uric acid, hominoid evolution, and the pathogenesis of salt-sensitivity. Hypertension 2002; 40: 355–360.

19. Parmar MS. Uric acid and cardiovascular risk. N Engl J Med 2009; 360: 539.

20. Glantzounis GK, Tsimoyiannis EC, Kappas AM, et al. Uric acid and oxidative stress. Curr Pharm Des 2005; 11: 4145–4151.

21. Scott GS, Hooper DC. The role of uric acid in protection against peroxynitrite-mediated pathology. Med Hypoth 2001; 56: 95–100.

22. Ames BN, Cathcart R, Schwiers E, et al. Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis. Proc Natl Acad Sci USA 1981; 78: 6858–6862.

23. Orowan E. The origin of man. Nature 1955; 175: 683–684.

24. Grivna M, Prusa R, Janda J. Urinary uric acid excretion in healthy male infants. Pediatr Nephrol 1997; 11: 623–624.

25. Seeman T, Pohl M, John U, et al. Ambulatory blood pressure, proteinuria and uric acid in children with IgA nephropathy and their correlation with histopathological findings. Kidney Blood Press Res 2008; 31: 337–342.

26. Malý J, Schück O. Influence of water and osmotic diuresis on renal uric acid excretion in man. I. In persons with normal renal function. Čas Lek čes 1972; 111: 2–7.

27. Malý J, Schück O. Renal uric acid excretion in patients with chronic pyelonephritis. Int Urol Nephrol 1973; 5: 209–216.

28. Malý J, Schück O, Nádvorníková H. Renal excretion of uric acid in chronic kidney disease. Čas Lek čes 1978; 117: 563–567.

29. Sebesta I, Krijt J, Pavelka K, et al. Familial juvenile hyperuricaemic nephropathy in adolescents. Adv Exp Med Biol 1994; 370: 73–76.

30. Bošmanský K, Pullmann R. Kyselina močová a jej význam v lekárskej praxi. Via Pract 2006; 3: 95–97.

31. Monhart V. Uric acid and cardiorenal risk. Kardiol Rev 2009; 11: 123–128.

32. Dukát A, Čelovská D, et al. Hypertenzia a hyperurikémia. Súč Klin Pr 2013; 1: 40–43.

33. Mahomed FA. On chronic Bright’s disease, and its essential symptoms. Lancet 1879; I: 398–404.

34. Gertler MM, Garn SM, Levine SA. Serum uric acid in relation to age and physique in health and in coronary heart disease. Ann Intern Med 1951; 34: 1421–1431.

35. Breckenridge A. Hypertension and hyperuricaemia. Lancet 1966; 1: 15–18.

36. Feig DI, Mazzali M, Kang D-H, et al. Serum uric acid: A risk factor and a target for treatment? J Am Soc Nephrol 2006; 17: S69–S73.

37. Mazzali M, Hughes J, Kim YG, et al. Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism. Hypertension 2001; 38: 1101–1106.

38. Mazzali M, Kanellis J, Han L, et al. Hyperuricemia induces a primary renal arteriolapathy in rats by a blood pressure-independent mechanism. Am J Physiol Renal Physiol 2002; 282: F991–F997.

39. Sanchez-Lozada LG, Soto V, Tapia E, et al. Role of oxidative stress in the renal abnormalities induced by experimental hyperuricemia. Am J Physiol Renal Physiol 2008; 295: F1134–F1141.

40. Khosla UM, Zharikov S, Finch JL, et al. Hyperuricemia induces endothelial dysfunction. Kidney Int 2005; 67: 1739–1742.

41. Nakagawa T, Mazzali M, Kang DH, et al. Hyperuricemia causes glomerular hypertrophy in the rat. Am J Nephrol; 23: 2–7.

42. Kang DH, Park SK, Lee IK, et al. Uric acid-induced C-reactive protein expression: Implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol 2005; 16: 3553–3562.

43. Kanellis J, Kang DH. Uric acid as a mediator of endothelial dysfunction, inflammation, and vascular disease. Semin Nephrol 2005; 25: 39–42.

44. Kanellis J, Watanabe S, Li JH, et al. Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension 2003; 41: 1287–1293.

45. Price KL, Sautin YY, Long DA, et al. Human vascular smooth muscle cells express a urate transporter. J Am Soc Nephrol 2006; 17: 1791–1795.

46. Lanaspa MA, Sanchez-Lozada LG, Cicerchi C, et al. Uric acid stimulates fructokinase and accelerates fructose metabolism in the development of fatty liver. PLoS ONE 2012,7.

47. Ryu E-S, Kim MJ, Shin H-S, et al. Uric acid-induced phenotypic transition of renal tubular cells as a novel mechanism of chronic kidney disease. Am J Physiol Renal Physiol 2013; 304: F471–F480.

48. Grayson PC, Kim SY, LaValley M, et al. Hy-peruricemia and incident hypertension: A systematic review and meta-analysis. Arthritis Care Res 2011; 63: 102–110.

49. Alper AB, Chen W, Yau L, et al. Childhood uric acid predicts adult blood pressure – The Bogalusa Heart Study. Hypertension 2005; 45: 34–38.

50. Gruskin AB. The adolescent with essential hypertension. Am J Kidney Dis 1985; 6: 86–90.

51. Feig DI, Johnson RJ. Hyperuricemia in childhood primary hypertension. Hypertension 2003; 42: 247–252.

52. Rovda II, Kazakova LM, Plaksina EA. Parameters of uric acid metabolism in healthy children and in pa-tients with arterial hypertension. Pediatriia 1990; 8: 19–22.

53. Prebis JW, Gruskin AB, Polinsky MS, et al. Uric acid in childhood essential hypertension. J Pediatr 1981; 98: 702–707.

54. Tomczak J, Wasilewska A, Milewski R. Urine NGAL and KIM-1 in children and adolescents with hyperuricemia. Pediatr Nephrol 2013; 28: 1863–1869.

55. Torok E, Gyarfas I, Csukas M. Factors associated with stable high blood-pressure in adolescents. J Hypertens 1985; 3: S389–S390.

56. Goldstein HS, Manowitz P. Relation between serum uric acid and blood pressure in adolescents. Ann Hum Biol 1993; 20: 423–431.

57. Jones DP, Richey PA, Alpert BS, et al. Serum uric acid and ambulatory blood pressure in children with primary hypertension. Pediatr Res 2008; 64: 556–561.

58. Loeffler LF, Navas-Acien A, Brady TM, et al. Uric acid level and elevated blood pressure in US adolescents. National Health and Nutrition Examination Survey, 1999–2006. Hypertension 2012; 59: 811-U145.

59. Viazzi F, Antolini L, Giussani M, et al. Serum uric acid and blood pressure in children at cardiovascular risk. Pediatrics 2013; 132: E93–E99.

60. Gaffo AL, Jacobs DR, Jr., Sijtsma F, et al. Serum urate association with hypertension in young adults: analysis from the coronary artery risk development in young adults cohort. Ann Rheum Dis 2013; 72: 1321–1327.

61. Feig DI, Rodriguez-Iturbe B, Nakagawa T, et al. Nephron number, uric acid, and renal microvascular disease in the pathogenesis of essential hypertension. Hypertension 2006; 48: 25–26.

62. Feig DI, Soletsky B, Johnson RJ. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension – A randomized trial. JAMA 2008; 300 (8): 924–932.

63. Soletsky B, Feig DI. Uric acid reduction rectifies prehypertension in obese adolescents. Hypertension 2012; 60: 1148–1156.

64. George J, Carr E, Davies J, et al. High-dose allopurinol improves endothelial function by profoundly reducing vascular oxidative stress and not by lowering uric acid. Circulation 2006; 114: 2508–2516.

65. Waring WS, McKnight JA, Webb DJ, et al. Lowering serum urate does not improve endothelial function in patients with type 2 diabetes. Diabetologia 2007; 50: 2572–2579.

66. Neogi T, George J, Rekhraj S, et al. Are either or both hyperuricemia and xanthine oxidase directly toxic to the vasculature? A critical appraisal. Arthritis Rheum 2012; 64: 327–338.

67. Hoieggen A, Alderman MH, Kjeldsen SE, et al. The impact of serum uric acid on cardiovascular outcomes in the LIFE study. Kidney Int 2004; 65: 1041–1049.

68. Roch-Ramel F, Guisan B, Diezi J. Effects of uricosuric and antiuricosuric agents on urate transport in human brush-border membrane vesicles. J Pharmacol Exp Ther 1997; 280: 839–845.

69. Baker JF, Krishnan E, Chen L, et al. Serum uric acid and cardiovascular disease: Recent developments, and where do they leave us? Am J Med 2005; 118: 816–826.

70. Hsia SH, Chou IJ, Kuo CF, et al. Survival impact of serum uric acid levels in children and adolescents. Rheumatol Int 2013; 33: 2797–2802.

71. Madero M, Arriaga JC, Jalal D, et al. The effect of two energy-restricted diets, a low-fructose diet versus a moderate natural fructose diet, on weight loss and metabolic syndrome parameters: a randomized controlled trial. Metabolism-Clinical and Experimental 2011; 60: 1551–1559.

72. Jalal DI, Smits G, Johnson RJ, et al. Increased fructose associates with elevated blood pressure. J Am Soc Nephrol 2010; 21: 1543–1549.

Labels
Neonatology Paediatrics General practitioner for children and adolescents
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