The Korean Journal of Medicine

  • 제80권5호
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  • Pages.524-528
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  • 2011
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지

고요산혈증은 신장, 심혈관 및 대사 질환의 발생/악화 인자인가?

Does Hyperuricemia Play a Causative Role in the Development and/or Aggravation of Renal, Cardiovascular and Metabolic Disease?

  • 강덕희 (이화여자대학교 의학전문대학원 내과학교실)
  • Kang, Duk-Hee (Department of Internal Medicine, Ewha Womans University School of Medicine)
  • 발행 : 2011.05.01
⟨ 이전 논문 다음 논문 ⟩

초록

Although an elevation of serum uric acid level is often associated with kidney disease, cardiovascular disease and metabolicsyndrome, it remains controversial whether hyperuricemia per se is a true risk factor for the development or aggravation of thesediseases. Recent studies have demonstrated the independent role of uric acid in progression of renal disease and the development ofnew-onset hypertension and diabetes. Furthermore, lowering uric acid in these patients is found to stabilize renal function anddecrease cardiovascular morbidity, suggesting the causative role of uric acid in renal, cardiovascular and metabolic disease, ratherthan an incidental association. In this manuscript, recent understanding about the role of uric acid in the development and/oraggravation of renal, cardiovascular and metabolic diseases will be reviewed based on the results from epidemiologic, clinical andexperimental studies.

키워드

참고문헌

  1. Oda M, Satta Y, Takenaka O, Takahata N. Loss of urate oxidase activity in hominoids and its evolutionary implications. Mol Biol Evol 2002;19:640-653. https://doi.org/10.1093/oxfordjournals.molbev.a004123
  2. Johnson RJ, Titte S, Cade JR, Rideout BA, Oliver WJ. Uric acid, evolution and primitive cultures. Semin Nephrol 2005;25:3-8. https://doi.org/10.1016/j.semnephrol.2004.09.002
  3. Tsimberidou AM, Keating MJ. Hyperuricemic syndromes in cancer patients. Contrib Nephrol 2005;147:47-60.
  4. Talbott JH, Terplan KL. The kidney in gout. Medicine (Baltimore) 1960;39:405-467.
  5. Greenbaum D, Ross JH, Steinberg VL. Renal biopsy in gout. Br Med J 1961;1:1502-1504. https://doi.org/10.1136/bmj.1.5238.1502
  6. Yu TF, Berger L, Dorph DJ, Smith H. Renal function in gout. V. Factors influencing the renal hemodynamics. Am J Med 1979; 67:766-771. https://doi.org/10.1016/0002-9343(79)90732-0
  7. Yu TF, Berger L. Impaired renal function gout. Its association with hypertensive vascular disease and intrinsic renal disease. Am J Med 1982;72:95-100. https://doi.org/10.1016/0002-9343(82)90593-9
  8. Berger L, Yu TF. Renal function in gout. Iv. An analysis of 524 gouty subjects including long-term follow-up studies. Am J Med 1975;59:605-613. https://doi.org/10.1016/0002-9343(75)90222-3
  9. Beck LH. Requiem for gouty nephropathy. Kidney Int 1986; 30:280-287. https://doi.org/10.1038/ki.1986.179
  10. Johnson RJ, Kivlighn SD, Kim YG, Suga S, Fogo AB. Reappraisal of the pathogenesis and consequences of hyperuricemia in hypertension, cardiovascular disease, and renal disease. Am J Kidney Dis 1999;33:225-234. https://doi.org/10.1016/S0272-6386(99)70295-7
  11. Kang DH, Nakagawa T, Feng L, et al. A role for uric acid in the progression of renal disease. J Am Soc Nephrol 2002;13:2888-2897. https://doi.org/10.1097/01.ASN.0000034910.58454.FD
  12. Sanchez-Lozada LG, Tapia E, Avila-Casado C, et al. Mild hyperuricemia induces glomerular hypertension in normal rats. Am J Physiol Renal Physiol 2002;283: F1105-1110.
  13. Iseki K, Ikemiya Y, Inoue T, Iseki C, Kinjo K, Takishita S. Significance of hyperuricemia as a risk factor for developing esrd in a screened cohort. Am J Kidney Dis 2004;44:642-650.
  14. Tomita M, Mizuno S, Yamanaka H, et al. Does hyperuricemia affect mortality? A prospective cohort study of japanese male workers. J Epidemiol 2000;10: 403-409. https://doi.org/10.2188/jea.10.403
  15. Iseki K, Oshiro S, Tozawa M, Iseki C, Ikemiya Y, Takishita S. Significance of hyperuricemia on the early detection of renal failure in a cohort of screened subjects. Hypertens Res 2001;24: 691-697. https://doi.org/10.1291/hypres.24.691
  16. Ben-Dov IZ, Kark JD. Serum uric acid is a gfr-independent long-term predictor of acute and chronic renal insufficiency: The jerusalem lipid research clinic cohort study. Nephrol Dial Transplant Jan 10, 2011 [Epub ahead of print]
  17. Myllymaki J, Honkanen T, Syrjanen J, et al. Uric acid correlates with the severity of histopathological parameters in iga nephropathy. Nephrol Dial Transplant 2005;20:89-95. https://doi.org/10.1093/ndt/gfh584
  18. Syrjanen J, Mustonen J, Pasternack A. Hypertriglyceridaemia and hyperuricaemia are risk factors for progression of iga nephropathy. Nephrol Dial Transplant 2000;15:34-42.
  19. Ohno I, Hosoya T, Gomi H, Ichida K, Okabe H, Hikita M. Serum uric acid and renal prognosis in patients with iga nephropathy. Nephron 2001;87:333-339. https://doi.org/10.1159/000045939
  20. Bo S, Cavallo-Perin P, Gentile L, Repetti E, Pagano G. Hypouricemia and hyperuricemia in type 2 diabetes: Two different phenotypes. Eur J Clin Invest 2001;31:318-321. https://doi.org/10.1046/j.1365-2362.2001.00812.x
  21. Kang DH, Yu ES, Park JE, Yoon KI, Kim MG, Johnson RJ. Uric acid-induced c-reactive protein (CRP) expression via upregulation of angiotensin type 1 receptors (AT1) in vascular endothelial cells and smooth muscle cells. J Am Soc Nephrol 2003;14:136A.
  22. 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. https://doi.org/10.1161/01.HYP.0000072820.07472.3B
  23. Siu YP, Leung KT, Tong MK, Kwan TH. Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis 2006;47:51-59. https://doi.org/10.1053/j.ajkd.2005.10.006
  24. Goicoechea M, de Vinuesa SG, Verdalles U, et al. Effect of allopurinol in chronic kidney disease progression and cardiovascular risk. Clin J Am Soc Nephrol 2010;5:1388-1393. https://doi.org/10.2215/CJN.01580210
  25. Culleton BF, Larson MG, Kannel WB, Levy D. Serum uric acid and risk for cardiovascular disease and death: The Framingham heart study. Ann Intern Med 1999;131:7-13. https://doi.org/10.7326/0003-4819-131-1-199907060-00003
  26. Feig DI, Soletsky B, Johnson RJ. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: A randomized trial. JAMA 2008;300:924-932. https://doi.org/10.1001/jama.300.8.924
  27. Madero M, Sarnak MJ, Wang X, et al. Uric acid and long-term outcomes in CKD. Am J Kidney Dis 2009;53:796-803. https://doi.org/10.1053/j.ajkd.2008.12.021
  28. Feig DI, Kang DH, Johnson RJ. Uric acid and cardiovascular risk. N Engl J Med 2008;359:1811-1821. https://doi.org/10.1056/NEJMra0800885
  29. Franse LV, Pahor M, Di Bari M, et al. Serum uric acid, diuretic treatment and risk of cardiovascular events in the systolic hypertension in the elderly program (SHEP). J Hypertens 2000;18: 1149-1154. https://doi.org/10.1097/00004872-200018080-00021
  30. Brodov Y, Behar S, Boyko V, Chouraqui P. Effect of the metabolic syndrome and hyperuricemia on outcome in patients with coronary artery disease (from the bezafibrate infarction prevention study). Am J Cardiol 2010;106:1717-1720. https://doi.org/10.1016/j.amjcard.2010.07.046
  31. Wiik BP, Larstorp AC, Hoieggen A, et al. Serum uric acid is associated with new-onset diabetes in hypertensive patients with left ventricular hypertrophy: The life study. Am J Hypertens 2010;23:845-851. https://doi.org/10.1038/ajh.2010.89
  32. Nakagawa T, Hu H, Zharikov S, et al. A causal role for uric acid in fructose-induced metabolic syndrome. Am J Physiol Renal Physiol 2006;290: F625-631.
  33. Tomiyama H, Higashi Y, Takase B, et al. Relationships among hyperuricemia, metabolic syndrome, and endothelial function. Am J Hypertens Apr 14, 2011 [Epub ahead of print]