Hyperuricemia in chronic kidney disease

Abstract

Introduction Chronic kidney disease (CKD) is a complex of symptoms, the result of the progressive loss of the number of nephrons. In the nephrological practice, patients with CKD represent 2.1-2.6%. It was observed that 20% of people with elevated uric acid developed CKD. Purpose The role of uric acid in chronic kidney disease. Material and methods Retrospective and prospective study on a group of 200 CKD patients hospitalized in the Nephrology department of the Republican Clinical Hospital "Timofei Moșneaga", during 2020-2021. All patients were clinically and paraclinically investigated. Conclusions 1.With the increase of serum uric acid there is an more severe stage of chronic kidney disease. 2.According to studies published in 2020 PERL and CKD FIX, even if hyperuricemia decreases, the progression of chronic kidney disease does not decrease. 3.Uric acid works to decrease renal perfusion by stimulating smooth muscle proliferation in the afferent arteriole. Uric acid decreases the bioavailability of nitric oxide (causing vasoconstriction) and increases the secretion of renin in the juxtaglomerular apparatus 4. Finally, intracellular uric acid increases the production of free radicals, thus triggering an inflammatory cascade that eventually results in the formation of fibrosis and glomerulosclerosis.