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Could uric acid have a role in acute renal failure?

Title
Could uric acid have a role in acute renal failure?
Authors
Ejaz, A. AhsanMu, WeiKang, Duk-HeeRoncal, CarlosSautin, Yuri Y.Henderson, GeorgeTabah-Fisch, IsabelleKeller, BirgitBeaver, Thomas M.Nakagawa, TakahikoJohnson, Richard J.
Ewha Authors
강덕희
SCOPUS Author ID
강덕희scopus
Issue Date
2007
Journal Title
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
ISSN
1555-905XJCR Link
Citation
vol. 2, no. 1, pp. 16 - 21
Publisher
AMERICAN SOCIETY NEPHROLOGY
Indexed
SCIE; SCOPUS WOS
Abstract
Acute renal failure (ARF), induced by either toxins or ischemia, is associated with significant morbidity. The pathogenesis of ARF is complex and is characterized by renal vasoconstriction and oxidative stress in association with tubular and microvascular injury and interstitial inflammation. In many situations, ARF is associated with a rise in serum uric acid as a result of both increased generation and decreased excretion. Although it is widely recognized that markedly elevated levels of uric acid can cause ARF via supersaturation within the tubules with crystallization and intrarenal obstruction ("acute urate nephropathy"), the possibility that uric acid may affect renal outcomes at concentrations that do not lead to tubular obstruction have not been considered. This article reviews both the salutary and the adverse effects of uric acid on biologic processes and presents the hypothesis that hyperuricemia, particularly if chronic and marked, likely represents a true risk factor for ARF. Hyperuricemia also may account for the paradoxic lack of benefit of diuretics in the management of ARF. It is suggested that studies are needed to investigate the role of chronic hyperuricemia on renal outcomes after acute tubular injury.
DOI
10.2215/CJN.00350106
Appears in Collections:
의과대학 > 의학과 > Journal papers
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