RELATIONSHIP BETWEEN MELATONIN-FORMING FUNCTION OF EPIPHYSIS WITH HYPERURICEMIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE 5 STAGES
About the author:
Petrova A., Karpenko O., Оstashevska T., Krasiuk E., Hryhorieva Y
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Aim. To analyze the prevalence of hyperuricemia in patients with stage 5 CKD treated with hemodialysis (HD) and to determine the relationship of pineal dysfunction with impaired purine metabolism. Object and methods. 130 people (50% of men) aged 58.5 were surveyed [43; 66] years on permanent hemodialysis treatment. Controls were 20 healthy individuals. The determination of daytime and nighttime levels of melatonin (MT) in saliva, based on the level of which, a group of patients with impaired MFE was isolated. Clinical and laboratory studies were carried out for all patients: general and biochemical blood tests with determination of uric acid level, office blood pressure (BP) measurements were performed. Results. Significant prevalence of MFE disorders in patients with stage 5 CKD treated with hemodialysis and its relationship to hyperuricemia has been identified. Analysis of uric acid (UC) levels between hemodialysis patients with stage 5 CKD and practically healthy subjects showed a higher value of 29.2% for patients with renal replacement therapy (NRT) (p <0.001). Conclusion. For patients with stage 5 CKD undergoing hemodialysis, there is a frequent violation of MFE (84.6%) and significant disorders of purine metabolism (74.6%). The analysis of the result of the study of purine metabolism showed more profound disorders in patients with impaired MFE, which may indicate a link between epiphysis dysfunction and hyperuricemia in patients with NRT. In patients with hemodialysis, disorders of purine metabolism are age-dependent and are determined by the duration of NRT, the experience of hypertension, hemoglobin levels, and MT levels. We have identified a relationship between impaired purine metabolism and MTF disturbance by daytime and nighttime MT.
chronic kidney disease, hemodialysis, melatonin, melatonin-forming function of the epiphysis, hyperuricemia, uric acid.
- Syniachenko OV, Ihnatenko HA, Mukhin IV. Kliniko-laboratorni aspekty purynovoho obminu: norma ta patolohiia. Medytsyna zaliznychnoho transportu Ukrainy. 2004;1:96-100. [in Ukrainian].
- Kapustianska AA. Rannia diahnostyka podahrychnoho artrytu na etapi pervynnoi medyko-sanitarnoi dopomohy. Svit medytsyny ta biolohii. 2013;4:104. [in Ukrainian].
- Bellomo G. The relationship between uric acid, allopurinol, cardiovascular events, and kidney disease progression: a step forward. American journal of kidney diseases: the official journal of the National Kidney Foundation. 2015;65:525-7. DOI: 10.1053/j.ajkd.2015.01.001
- Ichida K, Matsuo H, Takada T, Nakayama A, Keizo Murakami, Shimizu T, et al. Decreased extra-renal urate excretion is a common cause of hyperuricemia. Nat. Commun. 2012;3. DOI: 10.1038/ncomms1756
- Oh TR, Choi HS, Kim CS, Bae EH, Ma SK, Sung S, et al. Hyperuricemia has increased the risk of progression of chronic kidney disease: propensity score matching analysis from the KNOW-CKD study. Sci Rep. 2019. Available from: https://doi.org/10.1038/s41598-019-43241-3
- Tareevoj IE. Nefrologija. Medicina; 2000. s. 46-7. [in Russian].
- Baker J, Kimpinski K. Role of melatonin in blood pressure regulation: An adjunct anti-hypertensive agent. Clin Exp Pharmacol Physiol. 2018 Aug;45(8):755-66. DOI: 10.1111/1440-1681.12942
- Srivastava A, Kaze AD, McMullan CJ, Isakova T, Waikar SS. Uric Acid and the Risks of Kidney Failure and Death in Individuals With CKD. American journal of kidney diseases: the official journal of the National Kidney Foundation. 2018;71:362-70. DOI: 10.1053/j.ajkd.2017.08.017
- Nabavi SM, Nabavi SF, Sureda A, Xiao J, Dehpour AR, Shirooie S, et al. Anti-inflammatory effects of melatonin: a mechanistic review. Crit Rev Food Sci Nutr. 2019;59(1):4-16. DOI: 10.1080/10408398.2018.1487927
- Cuzzocrea S, Russel J Reiter. Pharmacological Actions of Melatonin in Acute and Chronic Inflammation. Current Topics in Medicinal Chemistry. 2002;2(2). DOI: 10.2174/1568026023394425
- Anisimov VN, Popovich IG, Zabezhinski MA. Melatonin as antioxidant, geroprotector and anticarcinogen. Biochim. Biophys. 2006;1757:573- 89.
- Russcher M, Koch B, Nagtegaal E, van der Putten K, ter Wee P, Gaillard C. The role of melatonin treatment in chronic kidney disease. Front. Biosci. (Landmark Ed). 2012;17:2644-56.
- Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European Heart Journal. 2018;39(33):3021-104. Available from: https://doi.org/10.1093/eurheartj/ehy339
- Ramirez MEG, Bargma JM. Treatment of asymptomatic hyperuricemia in chronic kidney disease: a new target in an old enemy. Journal of Advanced Research. 2017;8:551-4. Available from: https://doi.org/10.1016/j.jare.2017.04.006
- Kondratiuk VE, Petrova AS, Karpenko OV. Kharakterystyka melatoninutvoriuvalnoi funktsii epifiza u patsiientiv z khronichnoiu khvoroboiu nyrok u terminalnii stadii. Klinichna endokrynolohiia ta endokrynna khirurhiia. 2019;4:94-102. DOI: http://dx.doi.org/10.30978/CEES-2019- 4-94 [in Ukrainian].
- Hodzhakuliev BG, Begencheva GO, Ahmedova DM, Muhammedov MB, Kulyeva JeS. Klinicheskoe znachenie giperurikemii i obmena mochevoj kisloty v patologii serdechno-sosudistoj sistemy. Molodoj uchenyj. 2014;18:178-84. Dostupno: https://moluch.ru/archive/77/13123 [in Russian].
- Raja S, Kumar A, Aahooja RD, Thakuria U, Ochani S, Shaukat F. Frequency of Hyperuricemia and its Risk Factors in the Adult Population. Cureus. 2019;11(3). DOI: 10.7759/cureus.4198
- Ruilope LM, Garcia-Puig J. Hyperuricemia and Renal Function. Current Hypertension Reports. 2001;3:197-202.
Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 (155), 2020 year, 183-187 pages, index UDK 616.61–008.6–036.11–053.2-037