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Abstract: PO0035

Relationship Between Serum Uric Acid Levels and Reduction in Kidney Function Associated with Blockade of the Renin-Angiotensin System

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Nava, Marcos Garcia, Instituto Nacional de Cardiologia Ignacio Chavez, Nephrology Department, Mexico, Estado de Mexico, Mexico
  • Núñez, María Guadalupe Campos, Instituto Nacional de Cardiologia Ignacio Chavez, Nephrology Department, Mexico, Estado de Mexico, Mexico
  • Gudiño Bravo, Pedro, Instituto Nacional de Cardiologia Ignacio Chavez, Nephrology Department, Mexico, Estado de Mexico, Mexico
  • Fonseca Chávez, Alfredo, Instituto Nacional de Cardiologia Ignacio Chavez, Nephrology Department, Mexico, Estado de Mexico, Mexico
  • Rodriguez-Iturbe, Bernardo, Instituto Nacional de Cardiologia Ignacio Chavez, Nephrology Department, Mexico, Estado de Mexico, Mexico
  • Madero, Magdalena, Instituto Nacional de Cardiologia Ignacio Chavez, Nephrology Department, Mexico, Estado de Mexico, Mexico
Background

Renin-angiotensin system blockade(RASb) induced by treatment with angiotensin type 2 receptor antagonists and angiotensin converting enzyme inhibitors is frequently associated with a reduction in glomerular filtration rate(GFR).Experimental hyperuricemia is associated with dysregulation of renal hemodynamics and reduced GFR.We studied if serum uric acid(sUA) levels are related to the depression of renal function associated to RASb

Methods

107 patients(23-77 years,53 females) when they were first prescribed RASb for primary hypertension(PHT)(n=25),diabetic nephropathy(DN)(n=12),PHT&DN(n=8),congestive heart failure(n=26) and proteinuric nephropathes(n=36).Changes in serum creatinine(Scr),mean sUA levels and systolic(SBP) and diastolic(DBP) blood pressures(mmHg) were obtained from records before and 3,1±0,2 months after RASb

Results

Baseline eGFR(ml/min/1,73m2) was 43,6±2,81 and 64±4,89 in male and female patients,respectively.55% male and 51% female patients increased Scr with RASb but only 8 male and 2 female patients increased baseline Scr more than 0,3mg/dl.RASb reduced significantly SBP (pre130,7±1,67 vs. post124,1±1,57,p=0,004) but not DBP. Reduction in eGFR was found in 87% of the patients in whom SBP was reduced by RASb.Reduction of SBP was unrelated to the increase in Scr. sUA(mg/dl) was 6,9±018(males) and 6,1±0,23(females) (p=0,09).In female there was no relation between UA levels and change in Scr.In male there was a direct relationship between changes in Scr (ScrPre/ScrPost) and the mean serum UA levels(r:0,36, p=0,008) that was unrelated to SBP changes.Relationship was stronger in male patients with sUA ≥7,0(r=0.051)

Conclusion

Since 14% of the male patients treated with RASb increased Scr more than 0,3 mg/dl and deterioration of kidney function was directly related to sUA levels, the potential benefit of reducing sUA in male patients treated with RASb should be investigated further