Jennifer Finch | PubMed Health

PubMed2004

Uric acid, endothelial dysfunction and pre-eclampsia: searching for a pathogenetic link.

BACKGROUND: Pre-eclampsia is strongly associated with hyperuricemia, and in some studies the increase in serum uric acid has been found to correlate with both maternal and fetal morbidity. The hyperuricemia is believed to result primarily from the decreased renal excretion that occurs as a consequence of the pre-eclampsia, and as such is widely viewed as a marker for pre-eclampsia as opposed to having a role in the pathogenesis. HYPOTHESIS: We present the hypothesis that hyperuricemia may also have a contributory role in the development of hypertension and renal disease in these patients, and we review recent experimental data that would support this hypothesis. RECOMMENDATION: We suggest that studies addressing the role of uric acid in pre-eclampsia may provide new insights into both the pathogenesis and treatment of this condition.

Endothelium, Vascular↗

PubMed2004

Hypothesis: Uric acid, nephron number, and the pathogenesis of essential hypertension.

BACKGROUND: Essential hypertension affects more than 25% of the world's population. Genetic, physiologic, and epidemiologic studies provide clues to its origins, but a clear understanding has been elusive. Recent experimental and clinical studies have implicated uric acid in the onset of essential hypertension. METHODS: In a retrospective chart review, we identified 95 children with confirmed, new onset hypertension, and evaluated the cause of hypertension and parental history of hypertension, birth weight, and serum uric acid. In an open-label, cross-over trial we treated 5 children with confirmed essential hypertension with allopurinol as single treatment agent, and screened for change in blood pressure by casual and ambulatory methods. In tissue culture experiments, we evaluated the effect of uric acid on glomerular endothelial cell function. RESULTS: Elevation of serum uric acid is related to the onset of essential hypertension in children, reduced birth weight, and endothelial dysfunction. Normalization of uric acid appears to ameliorate new onset essential hypertension. CONCLUSION: These findings, combined with animal model data, support the hypothesis that uric acid has a key role in the pathogenesis of early onset essential hypertension, and may unify some of the disparate theories of the origins of essential hypertension.

Animals↗