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Uric Acid, Allopurinol: The Cardio-Renal Silver Bullet?

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Cardio-Renal Clinical Challenges

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Abstract

Elevated uric acid concentration is a common laboratory finding in subjects with metabolic syndrome/obesity, hypertension, kidney failure and cardiovascular events. Uric acid is the end product of purine metabolism that circulates in the plasma at concentrations varying from 2 to 10 mg/dl or higher. Purine nucleotides are derived from both exogenous (alimentary intake, especially animal proteins) and endogenous sources (de novo molecule synthesis and nucleic acid breakdown in the liver, intestines and other tissues – muscles, kidneys and the vascular endothelium). Purine catabolism involves several intermediate products (inosine, hypoxanthine, xanthine), and as a final step, xanthine oxidase catalyzes oxidation of xanthine to uric acid. Under normal conditions, the kidneys eliminate two-thirds of the uric acid production while the biliary tree removes the remaining one-third [1]. In the kidney, uric acid is filtered by the glomerulus and subsequently reabsorbed by the proximal tubes. Normal fractional excretion of uric acid is ~10 % [2].

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Authors and Affiliations

  1. Department of Nephrology, C.I. Parhon University Hospital, Gr T. Popa, University of Medicine and Pharmacy, Bdul Carol Nr 50, Iasi, 700506, Romania

    Adrian Covic MD, PhD, FRCP (London), FERA & Luminita Voroneanu MD, PhD

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  1. Adrian Covic MD, PhD, FRCP (London), FERA
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  2. Luminita Voroneanu MD, PhD
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Correspondence to Luminita Voroneanu MD, PhD .

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Editors and Affiliations

  1. Renal and Transplantation Department, Guy's Hospital, London, United Kingdom

    David Goldsmith

  2. Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania

    Adrian Covic

  3. Karolinska Institutet Danderyd University Hospital, Stockholm, Sweden

    Jonas Spaak

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Covic, A., Voroneanu, L. (2015). Uric Acid, Allopurinol: The Cardio-Renal Silver Bullet?. In: Goldsmith, D., Covic, A., Spaak, J. (eds) Cardio-Renal Clinical Challenges. Springer, Cham. https://doi.org/10.1007/978-3-319-09162-4_7

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