Title: A Hospital Based Study on Serum Uric Acid and Renal Function in Hypertensive Subjects of Northeast India
Authors: Dr Nirmali Mattack, Dr Elteza Tahziba Jahir, Dr Tridip Kutum
DOI: https://dx.doi.org/10.18535/jmscr/v4i12.55
Abstract
This is a case control study which involved 50 hypertensive subjects and 50 normotensive subjects and was carried out in Gauhati Medical College and Hospital. Subjects having systolic BP more than 140mm Hg and Diastolic BP more than 90mm Hg were considered hypertensive. Serum uric acid, urea and creatinine were evaluated in both the case and control groups in VITROS 5600. eGFR was estimated using online calculator based on the UK CKD eGuide on the Renal Association website. Statistical evaluation was done using unpaired student t test and Pearson correlation. The case group had an extremely significant high serum uric acid (p<0.0001) serum urea(p<0.0001) and serum creatinine (p=0.0009) compared to the control group, whereas eGFR was extremely significantly lower in the case group(p<0.0001). A significant negative correlation (r=-0.641, p<0.0001) was found between serum uric acid and eGFR. This study suggests that uric acid might indeed have a role in mediating hypertension via various mechanisms, and that renal function is closely associated with serum uric acid levels. Therefore, for screening of hypertension, periodic assessment of serum uric acid might be considered.
Keywords: Hypertension, uric acid, urea, creatinine, Egfr.
References
1. Johnson RJ, Segal MS, Srinivas T, Ejaz A, Mu W, Roncal C, Laura G, Lozada S, Gersch M, Bernardo Rodriguez-Iturbe B, Kang DH, Acosta JH 2005, ‘Essential Hypertension, Progressive Renal Disease, and Uric Acid: A Pathogenetic Link?’, J Am Soc Nephrol 16: 1909–1919
2. Nguedia Assob JC, Ngowe MN, Nsagha DS, Njunda AL, Waidim Y, et al. (2014) The Relationship between Uric Acid and Hypertension in Adults in Fako Division, SW Region Cameroon. J Nutr Food Sci 4: 257. doi: 10.4172/2155- 9600.1000257
3. Lee JJ, Ahn J, Hwang J, Han SW, Lee KN, Kim JB, Lee S, Na JO, Lim HE, Kim JW, Rha SW, Park CG, Seo HS, Oh DJ and Kim EJ 2015, ‘Relationship between uric acid and blood pressure in different age groups’; Clinical Hypertension 21:14
4. Harris ED, Budd RC, Firestein GS, Genovese MC, Sergent JS, et al. (2005) Kelly’s Textbook of Rheumatology 7th edn. USA: Elsevier Saunders.
5. Mahomed FA (1979) On chronic Bright’s disease, and its essential symptoms. Lancet 1: 399-401.
6. Haig A (1889) On Uric Acid and Arterial Tension. Br Med J 1: 288-291.
7. Davis N (1897) The cardiovascular and renal relations and manifestations of gout. JAMA 29:261-262.
8. Facchini F, Chen YD, Hollenbeck CB, Reaven GM (1991) Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA 266: 3008-3011.
9. Mbanya JC, Minkoulou EM, Salah JN, Balkau B (1998) The prevalence of hypertension in rural and urban Cameroon. Int J Epidemiol 27: 181-185.
10. Sobngwi E, Mbanya JC, Unwin NC, Porcher R, Kengne AP, et al. (2004) Expo-sure over the life course to an urban envir-onment and its relation with obesity, diab-etes, and hypertension in rural and urban Cameroon. Int J Epidemiol 33: 769-776.
11. de Ramirez SS, Enquobahrie DA, Nyadzi G, Mjungu D, Magombo F, et al. (2010) Prevalence and correlates of hypertension: a cross-sectional study among rural populations in sub-Saharan Africa. J Hum Hypertens 2: 786-795.
12. Lin F, Zhang H, Huang F, Chen H, Lin C, 3 and Zhu P 2016, ‘Influence of changes in serum uric acid levels on renal function in elderly patients with hyperte-nsion: a retrospective cohort study with 3.5-year follow-up’ BMC Geriatrics 16:35
13. Logan A 2011, ‘Hypertension in aging patients’, Expert Rev. Cardiovasc. Ther. 9(1), 113–120 (2011)
14. Silva SSBE, Oliveira SFSB, Pierin AMG. The control of hypertension in men and women: a comparative analysis. Rev Esc Enferm USP. 2016;50(1):50-8.
15. Coresh J, Wei GL, McQuillan G, Brancati FL, Levey AS, Jones C, Klag MJ, ‘Prevalence of High Blood Pressure and Elevated Serum Creatinine Level in the United States Findings From the Third National Health and Nutrition Examination Survey (1988-1994)’, Arch Intern Med. 2001;161(9):1207-1216
16. Yadav R, Bhartiya JP, Verma SK, Nandkeoliar MK, ‘Evaluation of blood urea, creatinine and uric acid as markers of kidney functions in hypertensive patients: a prospective study’, Indian Journal of Basic and Applied Medical Research; March 2014: Vol.-3, Issue- 2, P.682-689
17. Feig D 2012, ‘Advances in Chronic Kidney Disease’, Vol 19, No 6 (November): pp 377-385
18. Miyatake N, Shikata K, Makino H, Numata T 2011, ‘Decreasing serum uric acid levels might be associated with improving estimated glomerular filtration rate (eGFR) in Japanese men’, Vol.3, No.8, 498-503
19. Xu et al 2016, ‘The impact of serum uric acid on the natural history of glomerular filtration rate: a retrospective study in the general population’. PeerJ 4:e1859.