Renal insufficiency: uric acid does not degrade renal function

The elevation of uric acid in the blood is not a cause of chronic renal failure according to a new study. This is a consequence and treatment is unlikely to reduce the risk of kidney disease.

Studies have shown a strong association between high levels of uric acid in the blood ("hyperuricemia") and the risk of chronic renal failure. High levels of uric acid are often seen in chronic kidney disease, but the problem is that it is unclear whether this hyperuricemia is the cause or consequence of kidney disease.

To determine whether the level of uric acid in the blood has a causal effect on chronic kidney failure, a research team used a new method known as "Mendelian Randomization". It appears from this analysis based on genetic variation in the normal that there is no significant causal link between the level of uric acid in the blood and the risk of chronic renal failure. The study is published in PLOS Genetics.

No impact on kidney function

The elevation of uric acid in the blood is more likely to be a consequence of chronic renal failure and there is little chance that a reduction in uric acid levels in the blood with "hypouricemic" treatment reduce the risk of developing chronic kidney disease.

Several clinical trials have been launched to see if drugs that reduce uric acid in the blood ("hypouricemic") can prevent chronic renal failure. Studies that have looked at whether uric acid levels in the blood have a causal effect on chronic renal failure were limited by the insufficient number of people analyzed. Moreover, since they were epidemiological studies (a bit like a poll at a time t), they did not really allow a causal link to be established.

Mendelian randomization

This new study is based on analyzes carried out on four population groups and the UK's Great Biobank (UK BioBank). The methodology known as "Mendelian Randomization" tests whether genetic variants known to naturally increase a risk factor, and in this case uric acid levels in the blood, also increase the risk of an illness. , and in this case, chronic renal failure.

Some people have a genetically determined uric acid that is a little higher than average in the blood, with no real cause of hyperuricemia, as well as having a naturally slightly higher cholesterol or blood pressure. It is therefore possible to correlate this increase with that of the disease risk analyzed in the study.

Chronic renal failure

About 10% of the world's population suffers from chronic kidney disease, a condition that can lead to end-stage renal failure. At this stage, the disease requires dialysis or kidney transplant.

Treatment options for chronic kidney disease are limited and are primarily focused on controlling blood pressure, diabetes and its complications. The search for new therapeutic targets to prevent end-stage renal failure is therefore a public health priority.

Video: Dr. Stephen Phinney: Does a ketogenic diet cause kidney problems? (December 2019).