Only Hyperuricemia with Crystalluria, but not Asymptomatic Hyperuricemia, Drives Progression of Chronic Kidney Disease
Does elevated uric acid blood levels without symptoms of gout affect the progression of kidney disease?
A new study tried to answer this question. Previous data suggested that elevated asymptomatic uric acid could be a risk factor for the progression of CKD. However, a recent study published in NEJM last year 6/2020) found no benefit from lowering uric acid using allopurinol to slow the progression of CKD.
This new study found that it is not about the level of uric acid in the blood but about the presence of uric acid (UA) crystals in the urine. UA crystallizes in the kidney. UA crystals contribute to CKD progression because UA crystals trigger M1-like macrophage-related interstitial inflammation and fibrosis.
This study points to the limitation of conventional research that doesn’t look into the individual characteristics of each patient and point to the importance of using the simple and inexpensive urinalysis to help guide risk assessment and approach to managing uric acid in CKD.
https://jasn.asnjournals.org/content/31/12/2773
Association Between Midlife Physical Activity and Incident Kidney Disease: The Atherosclerosis Risk in Communities (ARIC) Study
Fresh from January’s American Journal of Kidney Disease:
Physical activity decreases the incidence of kidney disease… not surprisingly
Making lifestyle changes can be challenging, but are an important part of the fight against kidney disease. It can be a challenging process but understanding the brain’s efficacy and patterns can help individuals make the changes needed to lead a healthier lifestyle. Read more on our blog.
https://pubmed.ncbi.nlm.nih.gov/32971191/
Effect of Kidney Function on Relationships between Lifestyle Behaviors and Mortality or Cardiovascular Outcomes: A Pooled Cohort Analysis
In this study, investigators found that lifestyle modifications can reduce the risk of cardiovascular disease in patients with kidney function. They looked at smoking cessation, maintaining normal BMI, physical activity, healthy diet and moderate consumption of alcohol individually and in combination. Beside smoking cessation and physical activity, other individual lifestyle modifications were not sufficient alone according to this study. This emphasizes the importance of an integrative approach to kidney health and disease.
https://jasn.asnjournals.org/content/early/2021/02/04/ASN.2020040394
Laxative Use and Risk of Dyskalemia in Patients with Advanced CKD Transitioning to Dialysis
In this article, researchers found that using laxatives alone can help maintain potassium balance in patients with advanced kidney disease. The colon can actually play an important role in potassium excretion. That is one of the many reasons why a diet high in fiber is essential for kidney patients.
https://jasn.asnjournals.org/content/early/2021/02/04/ASN.2020081120
