Uric Acid as a Risk Factor for Chronic Kidney Disease and Cardiovascular Disease　― Japanese Guideline on the Management of Asymptomatic Hyperuricemia ―

• Hisatome Ichiro

  Division of Regenerative Medicine and Therapeutics, Department of Genetic Medicine and Regenerative Therapeutics, Institute of Regenerative Medicine and Biofunction, Tottori University Graduate School of Medical Science

• Li Peili

  Division of Regenerative Medicine and Therapeutics, Department of Genetic Medicine and Regenerative Therapeutics, Institute of Regenerative Medicine and Biofunction, Tottori University Graduate School of Medical Science

• Miake Junichiro

  Department of Pharmacology, Tottori University Faculty of Medicine

• Taufiq Fikri

  Department of Physiology, Faculty of Medicine, Sultan Agung Islamic University

• Mahati Endang

  Department of Pharmacology and Therapy, Faculty of Medicine, Diponegoro University

• Maharani Nani

  Department of Pharmacology and Therapy, Faculty of Medicine, Diponegoro University

• Utami Sulistiyati Bayu

  Department of Cardiology and Vascular Medicine, Faculty of Medicine, Diponegoro University

• Kuwabara Masanari

  Intensive Care Unit and Department of Cardiology, Toranomon Hospital

• Bahrudin Udin

  Department of Cardiology and Vascular Medicine, Faculty of Medicine, Diponegoro University

• Ninomiya Haruaki

  Department of Biological Regulation, Tottori University Faculty of Medicine

抄録

Serum uric acid (UA) is taken up by endothelial cells and reduces the level of nitric oxide (NO) by inhibiting its production and accelerating its degradation. Cytosolic and plasma xanthine oxidase (XO) generates superoxide and also decreases the NO level. Thus, hyperuricemia is associated with impaired endothelial function. Hyperuricemia is often associated with vascular diseases such as chronic kidney disease (CKD) and cardiovascular disease (CVD). It has long been debated whether hyperuricemia is causally related to the development of these diseases. The 2020 American College of Rheumatology Guideline for the Management of Gout (ACR2020) does not recommend pharmacological treatment of hyperuricemia in patients with CKD/CVD. In contrast, the Japanese Guideline on Management of Hyperuricemia and Gout (JGMHG), 3^rdedition, recommends pharmacological treatment of hyperuricemia in patients with CKD. In a FREED study on Japanese hyperuricemic patients with CVD, an XO inhibitor, febuxostat, improved the primary composite endpoint of cerebro-cardio-renovascular events, providing a rationale for the use of urate-lowering agents (ULAs). Since a CARES study on American gout patients with CVD treated with febuxostat revealed increased mortality, ACR2020 recommends switching to different ULAs. However, there was no difference in the mortality of Japanese patients between the febuxostat-treated group and the placebo or allopurinol-treated groups in either the FEATHER or FREED studies.

収録刊行物

• Circulation Journal

  Circulation Journal 85 (2), 130-138, 2021-01-25

  一般社団法人 日本循環器学会

キーワード

• Cardio-renal continuum
• CARES study
• Urate-lowering agent
• Uric acid transporter
• Xanthine oxidase

詳細情報

• CRID: 1391975831238951680
• NII論文ID: 130007975319
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-20-0406
• ISSN: 13474820
• ISSN: 13469843
• NDL書誌ID: 031256558
• PubMed: 33342914
• Web Site: https://repository.lib.tottori-u.ac.jp/records/7155
• Web Site: http://id.ndl.go.jp/bib/031256558
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I031256558
• Web Site: https://www.jstage.jst.go.jp/article/circj/85/2/85_CJ-20-0406/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2021325633
• 本文言語コード: en
• データソース種別:
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