Gigante Antonietta, Pellicano Chiara, Gallicchio Carmen, Melena Michele, Fiorino Melania, Rosato Edoardo, Giannakakis Konstantinos, Ascione Andrea, Muscaritoli Maurizio, Cianci Rosario
Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
High Blood Press Cardiovasc Prev. 2025 Mar;32(2):165-170. doi: 10.1007/s40292-024-00699-1. Epub 2024 Dec 24.
Increased serum uric acid (SUA) levels are found in cardiovascular and kidney diseases, associated with the development of vascular injury. Uric acid stimulates the inflammatory pathways, promotes vascular smooth muscle cells proliferation, activates renin-angiotensin system leading to the development and progression of vascular damage. Renal function-normalized uric acid [SUA to serum creatinine ratio (SUA/SCr)] has been suggested to be a better indicator of uric acid.
To investigate the correlation between SUA level and SUA/SCr in the development of chronic and vascular lesions (CVL) in patients with primary glomerulonephritis (GN).
A retrospective observational study was conducted in 95 consecutive renal native biopsies performed at Policlinico Umberto I of Rome (Italy). Patient inclusion criteria were age ≥ 18 years, a renal biopsy confirming diagnosis of primary GN, the availability of complete demographic, clinical, pathological, and laboratory data.
Median SCr was 1.06 mg/dl (IQR 0.77;1.70) with a median eGFR of 70.40 ml/min (IQR 40.40;105). Median SUA was 5.90 mg/dl (IQR 4.30;6.90) and median SUA/SCr was 4.70 (IQR 3.20;6.80). CVL were reported in 56 (58.9%) patients. Median SUA/SCr was significantly lower in patients with CVL than patients without CVL [3.95 (IQR 2.65;6) vs 5.90 (IQR 4.30;7.20), p<0.01]. Logistic regression analysis showed that SUA/SCr ≤ 4.05 [OR 5.451 (95% CI 1.222;24.325), p<0.05] was independently associated with CVL.
CVL play a crucial role in the progression of kidney disease. SUA/SCr ≤ 4.05 is associated with CVL in patients with primitive GN.
在心血管疾病和肾脏疾病中发现血清尿酸（SUA）水平升高，这与血管损伤的发展有关。尿酸刺激炎症途径，促进血管平滑肌细胞增殖，激活肾素 - 血管紧张素系统，导致血管损伤的发生和进展。肾功能标准化尿酸[SUA与血清肌酐比值（SUA/SCr）]被认为是尿酸的更好指标。
研究原发性肾小球肾炎（GN）患者慢性和血管病变（CVL）发展过程中SUA水平与SUA/SCr之间的相关性。
在意大利罗马翁贝托一世综合医院连续进行的95例肾穿刺活检中进行了一项回顾性观察研究。患者纳入标准为年龄≥18岁，肾穿刺活检确诊为原发性GN，可获得完整的人口统计学、临床、病理和实验室数据。
血清肌酐（SCr）中位数为1.06mg/dl（四分位间距IQR 0.77；1.70），估算肾小球滤过率（eGFR）中位数为70.40ml/min（IQR 40.40；105）。SUA中位数为5.90mg/dl（IQR 4.30；6.90），SUA/SCr中位数为4.70（IQR 3.20；6.80）。56例（58.9%）患者报告有CVL。有CVL的患者SUA/SCr中位数显著低于无CVL的患者[3.95（IQR 2.65；6）对5.90（IQR 4.30；7.20），p<0.01]。逻辑回归分析显示，SUA/SCr≤4.05[比值比OR 5.451（95%置信区间CI 1.222；24.325），p<0.05]与CVL独立相关。
CVL在肾脏疾病进展中起关键作用。SUA/SCr≤4.05与原发性GN患者的CVL相关。
