Hyperuricemia is associated with secondary hyperparathyroidism in patients with chronic kidney disease

被引:2
|
作者
Costa, Tiago Emanuel M. [1 ]
Lauar, Julia C. [1 ]
Innecchi, Mariana L. R. [1 ]
Coelho, Venceslau A. [2 ]
Moyses, Rosa M. A. [1 ]
Elias, Rosilene M. [1 ,3 ]
机构
[1] Hosp Clin HCFMUSP, Dept Med, Div Nephrol, Sao Paulo, SP, Brazil
[2] Hosp Clin HCFMUSP, Dept Med, Div Geriatr, Sao Paulo, SP, Brazil
[3] Univ Nove Julho UNINOVE, Sao Paulo, SP, Brazil
关键词
Hyperparathyroidism; Vitamin D; Allopurinol; Chronic kidney disease; Uric acid; VITAMIN-D STATUS; URIC-ACID; GOUT; POPULATION; MEGALIN; HEALTH; RISK;
D O I
10.1007/s11255-022-03116-5
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose Hyperuricemia is common among patients with chronic kidney disease (CKD). In the general population, hyperuricemia is associated with secondary hyperparathyroidism (SHPT), in a mechanism that involves vitamin D metabolism. Data for patients with CKD, however, are scarce. We aimed to evaluate the relationship between hyperuricemia and mineral and bone metabolism, particularly hyperparathyroidism. Methods This is a retrospective study that included 922 adult patients with stages 3, 4, or 5 CKD, not on dialysis. Clinical, demographic, and biochemical data were collected from charts and included uric acid, parathyroid hormone (PTH), 25(OH)-vitamin D, calcium, phosphate, renal function (estimated glomerular filtration rate-eGFR), and medications such as allopurinol, furosemide, and cholecalciferol. SHPT was defined as PTH > 65 pg/ml. Results Our patients were mostly Caucasian women, with a mean age of 64 +/- 16 years. SHPT and hyperuricemia were observed in 70% and 62.4% of patients, respectively. Patients with SHPT presented higher levels of uric acid (7.2 +/- 1.8 vs. 6.6 +/- 1.7 mg/dL, p = 0.0001) and a higher frequency of hyperuricemia (66% vs. 33%, p = 0.0001). Patients with hyperuricemia were mostly female, with lower eGFR, higher phosphate, and higher PTH. The risk of hypovitaminosis D was higher among patients with SHPT (69.7% vs. 53.1%, p = 0.0001). Hyperuricemia remained independently associated with hyperparathyroidism, (p = 0.033) even after adjustments for eGFR, calcium, phosphate, hypovitaminosis D, and use of allopurinol, calcitriol, furosemide, and cholecalciferol. Conclusion Hyperuricemia seems to be a contributing factor for SHPT in patients with CKD. The mechanisms behind this finding have yet to be elucidated.
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收藏
页码:2255 / 2261
页数:7
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