Program in Cardiovascular Sciences, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil.
Ren Fail. 2013;35(3):361-6. doi: 10.3109/0886022X.2013.764274. Epub 2013 Feb 11.
Elevated serum uric acid has been associated with a variety of cardiovascular disease and with inflammation, but these have been little explored in chronic kidney disease (CKD). Elevated uric acid levels are common in CKD patients and could be involved in inflammatory milieu; our aim was to analyze the association between uric acid and inflammatory markers in hemodialysis (HD) patients.
This was a cross-sectional study.
This study was conducted from private clinic, Rio de Janeiro, Brazil.
This study included 50 HD patients and 21 healthy subjects.
This study included 50 HD patients [62% men, 54.3 ± 12.6 years, 57.5 ± 50.1 months on dialysis, and body mass index (BMI), 24.4 ± 4.1 kg/m2] and 21 healthy individuals (45% men, 50.7 ± 15.7 years and BMI, 25.5 ± 4 kg/m2). Uric acid was measured using uricase-PAP method; inflammatory [tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP)] and atherosclerosis markers [intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), monocyte chemoattractant protein-1 (MCP-1), plasminogen activator inhibitor-1 (PAI-1)] were measured by a multiplexed assay.
PATIENTS presented high levels of TNF-α, IL-6, CRP, VCAM-1, ICAM-1 (5.5 ± 2.1 pg/mL, 4.1 ± 1.6 pg/mL, 0.32 ± 0.30 mg/mL, 48.5 ± 8.5 ng/mL, 20.5 ± 15.9 ng/mL, respectively), compared with healthy individuals (2.4 ± 1.1 pg/mL, 2.7 ± 0.4 pg/mL, 0.11 ± 0.12 mg/mL, 23.8 ± 5.5 ng/mL, 7.2 ± 1.2 ng/mL, respectively) ( p < 0.04). Uric acid levels were also higher in HD patients (5.4 ± 1.3 mg/dL) than in healthy individuals (3.9 ± 0.9 mg/dL) ( p < 0.02). There was a positive correlation between uric acid and inflammatory markers, IL-6 (r = 0.30, p = 0.01), CRP (r = 0.37, p = 0.003), TNF-α (r = 0.40, p = 0.001), ICAM-1 (r = 0.53, p = 0.0001), and VCAM-1 (r = 0.45, p = 0.0001).
These original data suggest that uric acid may have a role in inflammation and atherosclerosis in HD patients. However, further prospective studies involving intervention trials should be conducted in order to search for actual causality relationship between these markers.
血清尿酸水平升高与多种心血管疾病和炎症有关，但在慢性肾脏病（CKD）中，这些关联尚未得到充分研究。CKD 患者中尿酸水平升高较为常见，可能与炎症环境有关；我们的目的是分析血液透析（HD）患者尿酸与炎症标志物之间的关系。
这是一项横断面研究。
本研究在巴西里约热内卢的一家私人诊所进行。
本研究纳入了 50 名 HD 患者和 21 名健康对照者。
本研究纳入了 50 名 HD 患者[62%为男性，54.3±12.6 岁，57.5±50.1 个月开始透析，体重指数（BMI）为 24.4±4.1 kg/m2]和 21 名健康对照者（45%为男性，50.7±15.7 岁，BMI 为 25.5±4 kg/m2]。尿酸采用尿酸酶-PAP 法检测；炎症[肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、C 反应蛋白（CRP）]和动脉粥样硬化标志物[细胞间黏附分子-1（ICAM-1）、血管细胞黏附分子-1（VCAM-1）、单核细胞趋化蛋白-1（MCP-1）、纤溶酶原激活物抑制剂-1（PAI-1）]采用多重检测法检测。
与健康对照者（2.4±1.1 pg/mL、2.7±0.4 pg/mL、0.11±0.12 mg/mL、23.8±5.5 ng/mL、7.2±1.2 ng/mL）相比，患者（5.5±2.1 pg/mL、4.1±1.6 pg/mL、0.32±0.30 mg/mL、48.5±8.5 ng/mL、20.5±15.9 ng/mL）的 TNF-α、IL-6、CRP、VCAM-1、ICAM-1 水平更高（p<0.04）。HD 患者的尿酸水平（5.4±1.3 mg/dL）也高于健康对照者（3.9±0.9 mg/dL）（p<0.02）。尿酸与炎症标志物（IL-6、CRP、TNF-α、ICAM-1 和 VCAM-1）之间存在正相关（r=0.30，p=0.01；r=0.37，p=0.003；r=0.40，p=0.001；r=0.53，p=0.0001；r=0.45，p=0.0001）。
这些原始数据表明，尿酸可能在 HD 患者的炎症和动脉粥样硬化中起作用。然而，为了寻找这些标志物之间的实际因果关系，应进行进一步的前瞻性研究，包括干预试验。
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