Author Interviews, Gout, Kidney Disease, NEJM / 24.06.2020 Interview with: Sunil Badve MBBS, MD, DNB, FRACP, PhD, FASN Staff specialist nephrologist | St George Hospital Conjoint Associate Professor | University of New South Wales Senior Research Fellow, Acute Kidney Injury and Trials The George Institute for Global Health Australia What is the background for this study? Response: Elevated serum urate levels are associated with progression of chronic kidney disease (CKD). CKD patients often have elevated serum urate levels due to decreased excretion. We conducted this placebo-controlled randomized trial to evaluate if urate-lowering treatment with allopurinol would attenuate decline in estimated glomerular filtration rate (eGFR) over 2 years in patients with CKD. We enrolled 369 CKD patients with high progression risk and no prior history of gout. (more…)
Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Gout, Nutrition, Race/Ethnic Diversity / 19.01.2018 Interview with: “Blood Pressure” by Bernard Goldbach is licensed under CC BY 2.0Stephen P. Juraschek, MD, PhD Instructor of Medicine Beth Israel Deaconess Medical Center/Harvard Medical School What is the background for this study? What are the main findings? Response: Recent evidence suggests that the DASH diet is associated with lower uric acid levels and lower risk of gout. Furthermore, a secondary analysis of the DASH trial showed that complete replacement of a typical American diet with the DASH diet lowered uric acid levels. However, it is unknown if partial replacement of a typical American diet with DASH foods might lower uric acid. (more…)
Author Interviews, Kidney Stones, Urology / 25.01.2017 Interview with: Li Hao Richie Xu MD Division of Mineral Metabolism University of Texas Southwestern Medical Center Dallas, Texas, United States What is the background for this study? What are the main findings? Response: Over the past three decades, the prevalence of the kidney stones has escalated in the United States. Changes in dietary patterns, increasing body weight and obesity likely contributed to this significantly higher prevalence of kidney stone. In this study, we explored temporal changes in stone composition, demographic characteristics, and in serum and urinary kidney stone risk profile in kidney stone forming population for the last 35 years. The proportion of uric acid stones has been almost doubled during this period. Although age and body mass index (BMI) increased over time in both uric acid and calcium stone formers, uric acid stone formers were consistently older, had higher BMI, and lower urinary pH than calcium stone formers. In addition, over time, the proportion of female vs. male increased in calcium stone formers, but not in uric acid stone formers. The most significant urinary parameter differentiating uric acid stone formers from calcium stone formers is 24-hour urinary pH. (more…)
Author Interviews, Colon Cancer, Gout, NYU, Rheumatology / 20.11.2016 Interview with: Michael Pillinger, MD Professor of Medicine and Biochemistry and Molecular Pharmacology NYU School of Medicine What is the background for this study? What are the main findings? Response: We are interested in the co-morbidities of gout and the fact that gout is accompanied by multiple cardiovascular, renal and other events. The implications of gout for cancer are less clear, but the basic biology suggests that either: 1) the acute and chronic inflammation of gout could contribute to a pro-cancer environment; 2) the anti-oxidant effects of urate could have anti-cancer properties; 3) the ability of uric acid to serve as a "danger signal" released from dying cells (potentially including cancer cells" could promote anti-cancer immunity. The clinical literature is murky at best. (more…)
Author Interviews, Gout, Kidney Disease / 19.11.2016 Interview with: Gerald D. Levy MD Internal Medicine/Rheumatology Southern California Kaiser Permanente Downey, CA What are the main findings of your study? Patients with hyperuricemia and chronic kidney disease (CKD)  improve when serum Uric Acid (sUA) is brought below 6mg/dl with urate lowering therapy. We found a 6% improvement in this group compared to patients not at goal. More importantly the stage of CKD appears to be important with CKD II showing approximately 3% who improve with nearly 10% of patients improving in the CKD III group. We did not see benefit in those patients who are stage 4 CKD. (more…)
Author Interviews, Gout, Heart Disease, Kidney Disease, Mayo Clinic / 14.09.2015

Wisit Cheungpasitporn, MD Nephrology Fellow Departments of Nephrology and Hypertension Mayo Clinic, Rochester, Interview with: Wisit Cheungpasitporn, MD Nephrology Fellow Departments of Nephrology and Hypertension Mayo Clinic, Rochester, MN Program director: Suzanne Norby, MD Co-authors: Charat Thongprayoon, MD, Andrew M. Harrison, BS and Stephen B. Erickson, MD Project mentors: Stephen B. Erickson, MD Departments of Nephrology and Hypertension Mayo Clinic, Rochester, MN   Medical Research: What is the background for this study? Dr. Cheungpasitporn: Uric acid has been linked to acute kidney injury (AKI) through crystal-dependent pathways and crystal-independent mechanisms, including reduced renal blood flow and glomerular filtration rate. Serum uric acid measurement has recently been examined as a marker for early AKI detection, especially in the setting of postoperative AKI following cardiovascular surgery. The effect of admission serum uric acid levels on the risk of in-hospital AKI in the general hospitalized patients, however, was unclear. Thus, we conducted a study to assess the risk of AKI in all hospitalized patients across different serum uric acid levels. The findings of our study data were recently published in Clinical Kidney Journal. (more…)
AHA Journals, Author Interviews, Stroke / 13.07.2015 Interview with: Dr. Ángel Chamorro Director, Comprehensive Stroke Center Hospital Clinic Barcelona, Spain Medical Research: What is the background for this study? What are the main findings? Dr. Chamorro: There is a great need of new therapies in patients with acute stroke and our study is based on the clinical observation that patients with acute stroke recover better if at the time of the stroke the levels of uric acid are increased in their blood. That first observation led to a long way of research and administrative challenges but we finally came out with a solution of uric acid (a potent antioxidant) manufactured according to the strict rules which apply to drugs aimed for human use. Thus, we performed a pilot study that showed that uric acid could be safely administered to these patients. We then performed a larger clinical trial in 421 patients which provided very encouraging results overall. Now we are reporting in the Stroke journal appearing on July 9, that women obtained a much greater benefit than men because they had lower levels of uric acid than men because estrogens (female hormones) are efficient excretors of uric acid. In consequence, women were in greater need of uric acid replenishment following the stroke than men. (more…)
Author Interviews, Heart Disease / 16.09.2014

Muthiah Vaduganathan, MD MPH Department of Medicine Massachusetts General Hospital Boston, Interview with: Muthiah Vaduganathan, MD MPH Department of Medicine Massachusetts General Hospital Boston, Mass Medical Research: What are the main findings of the study? Dr. Vaduganathan: Based on data from a large, multinational randomized controlled trial of patients hospitalized for heart failure and reduced ejection fraction (HFrEF), we conducted a retrospective analyses of the clinical profiles associated with baseline serum uric acid levels. Serum uric acid was commonly elevated in patients hospitalized for heart failure and reduced ejection fraction (mean ~9 mg/dL), especially in men and black patients. Higher uric acid levels were associated with lower systolic blood pressure and EF, higher natriuretic peptides, and more impaired renal function. After accounting for 24 known baseline covariates, serum uric acid was independently predictive of post-discharge mortality and rehospitalization in patients with relatively preserved renal function, but not in those with poor renal function. (more…)