Uric acid in chronic kidney disease

Introduction Uric acid is the end product of purine metabolism in humans, and hyperuricemia was historically thought to cause only gout and urolithiasis. A number of more recent studies have suggested that uric acid may also play a role in hypertension, cardiovascular disease, metabolic syndrome and renal disease. Animal studies demonstrate that elevated uric acid level causes hypertension and endothelial dysfunction, arteriolopathy and chronic kidney disease. Observational studies in human subjects suggest an association of hyperuricemia with incident kidney disease; however, studies investigating the role of uric acid in chronic kidney disease progression have provided varied results. Small randomized-controlled trials investigating the use of uric-acid lowering drugs have provided promising results but larger interventional clinical trials are needed to establish the role of uric acid in these diseases. This review discusses the current understanding of uric acid in the various comorbidities and diseases managed by nephrologists. Conclusion Larger interventional clinical trials are needed to establish the role of uric acid in these diseases.


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Aims and Scope Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. Blood Purification also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities. Copyright: © 2018 S. Karger AG, Basel (Switzerland). All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

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Medical Statistics has never been easier!
The easiest way to order: w w w.karger.com/medical_ statistics The fifth revised edition of this highly successful book presents the most extensive enhancement since Using and Understanding Medical Statistics was first published 30 years ago. Without question, the single greatest change has been the inclusion of source code, together with selected output, for the awardwinning, open-source, statistical package known as R. This innovation has enabled the authors to deemphasize formulae and calculations, and let software do all of the 'heavy lifting' . This edition also introduces readers to several graphical statistical tools, such as Q-Q plots to check normality, residual plots for multiple regression models, funnel plots to detect publication bias in a metaanalysis and Bland-Altman plots for assessing agreement in clinical measurements. New examples that better serve the expository goals have been added to a half-dozen chapters. In addition, there are new sections describing exact confidence bands for the Kaplan-Meier estimator, as well as negative binomial and zero-inflated Poisson regression models for overdispersed count data. The end result is not only an excellent introduction to medical statistics, but also an invaluable reference for every discerning reader of medical research literature. The easiest way to order: w w w.karger.com/conep After years of stagnation, much has been happening in the diagnosis and treatment of kidney diseases. This book contains a comprehensive review of the main developments in AKI, CKD, hemodialysis and kidney transplantation. The section on AKI deals with the key innovations in extracorporeal technologies. The section on nephrology and CKD concentrates on mineral metabolism alterations, restenosis in hemodialytic fistulas, mycophenolate mofetil as an alternative treatment for IgA nephropathy, and the genetics and progression of autosomal dominant polycystic kidney disease. The part on hemodialysis includes contributions on expanded hemodialysis, potassium profiling and home hemodialysis. Chapters on the treatment of acute antibody-mediated rejection after transplantation, pathogenesis and therapy of chronic allograft injury, and non-invasive surrogate biomarkers of acute rejection round out the subjects covered. Due to the wide variety of topics included in each section, this book is not only of interest to nephrologists, but also to professionals from related fields.

Foreword
• Present and Future of Acute and Chronic Kidney Disease: