1.Evaluation of methodological and reporting quality of domestic clinical guidelines for hyperuricemia.
Dong-Jun WANG ; Ying ZHANG ; Zhi-Kui TIAN ; Mi ZHOU ; Yuan-Yuan GUAN ; Qing-Qing ZHU ; Zong-Hui ZHOU ; Xuan SUN ; Chun-Ying TIAN ; Hong-Wu WANG
China Journal of Chinese Materia Medica 2022;47(2):547-556
This study aims to evaluate the methodological and reporting quality of diagnosis and treatment guidelines for hyperuricemia as well as the expert consensuses and promote the understanding and application of the diagnosis and treatment guidelines for hyperuricemia. With "hyperuricemia" "guidelines" "consensus" "recommendations" as the key words in titles, the authors searched for the published clinical guidelines on hyperuricemia in Chinese against CNKI, Wanfang, VIP, Medlive and the official website of the industry association. The retrieval time limit was until May 31, 2021. The appraisal of guidelines for research and evaluation Ⅱ(AGREEⅡ) and the reporting items for practice guidelines in health care(RIGHT) were employed to evaluate the methodological quality and reporting quality of 14 guidelines/consensuses included. The average scores of the guidelines/consensuses were 80.85%(48.61%-98.61%) for the domain of scope and purpose, 34.52%(0-69.44%) for the domain of stakeholder involvement, 35.53%(6.25%-92.19%) for the domain of rigor of development, 55.85%(23.61%-86.11%) for the domain of clarity of presentation, 26.19%(0-76.04%) for the domain of applicability, and 21.42%(0-50.00%) for the domain of editorial independence. Nine guidelines/consensuses were of medium overall quality with grade B recommendation, and five guidelines/consensuses were of poor quality with grade C recommendation. The RIGHT classified the fourteen guidelines/consensuses into one of high reporting quality, three of medium reporting quality, and ten of low reporting quality. The results of this study indicate that the standardization and rigor of the methodological quality and the reporting quality of the clinical guidelines/consensuses for hyperuricemia in China remain to be strengthened.
China
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Consensus
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Humans
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Hyperuricemia/drug therapy*
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Publications
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Reference Standards
2.Tumor Lysis Syndrome in a Solid Tumor: A Case Report of a Patient with Invasive Thymoma.
Ji Yun LEE ; Sung Hee LIM ; Ji Young LEE ; Ji Hoon KIM ; Ki Hong CHOI ; Keunchil PARK ; Jong Mu SUN ; Jin Seok AHN ; Myung Ju AHN
Cancer Research and Treatment 2013;45(4):343-348
Tumor lysis syndrome (TLS) has rarely been observed in solid tumors. We report on a case of a patient with advanced invasive thymoma who developed tumor lysis syndrome after chemotherapy. The potential complications of TLS should be considered in treatment of extensive thymoma.
Acute Kidney Injury
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Drug Therapy
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Humans
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Hyperuricemia
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Thymoma*
;
Tumor Lysis Syndrome*
3.Follow-Up Study of 6-Month Short Course Chemotherapyfor Pulmonary Tuberculosis with 2SKHRZ/4HRZ.
Hyung Ki KOH ; Yun Jung KANG ; Seong Yong LIM ; Jong Wook SHIN ; Jae Sun CHOI ; Ji Hoon YOO ; In Won PARK ; Byoung Whui CHOI ; Sung Ho HUE ; Seung Chun SEO
Tuberculosis and Respiratory Diseases 1996;43(6):852-861
Background: Many clinicians have experienced the difficulty of decision on termination of antituberculosis chemotherapy after the 6th month due to relapse of disease. There is still controversy in the effect of 2S(K)HRZ/4HRZ 6-month short course chemotherapy including pyrazinamide for 6 months in patients with pulmonary tuberculosis. And there is no long term follow-up study of 6-month short course chemotherapy for pulmonary tuberculosis in korea. So we had performed the study to find the result of 6-month antituberculosis chemotherapy for 4 years. Method: We studied prospectively the effect of 2S(K)HRZ/4HRZ in one hundred-fifty patients with pulmonary tuberculosis and followed up fifty-nine patients for more than 1 year to 4 years after the completion of 6-month short course therapy. Results: 1) Out of one hundred-fifty patients, seventy-two patients(48%) completed the prescribed 6-month chemotherapy. Sixty-eight patients(45.3%) have experienced premature discontinuation and the most common cause of premature discontinuation was drop-out against advice(thirty-six patients, 24%). Ten patients(6.7%) were treated beyond the 6 months mainly due to irregular treatment. 2) Fifty-nine patients(81.9%) among seventy-two patients with completed treatment have been followed up for more than 1 year and 32 patients(44.4%) for more than 4 years. There was three relapse patients of whom two patients have experienced relapse of pulmonary tuberculosis within 1 year after the termination of chemotherapy. 3) Among one hundred-thirty-four patients who have been assessible for more than two months of chemotherapy, including the patients who experienced within 2 months, there were eighty-two patients(61.2%) who have experienced adverse reactions and the treament regimen was changed only in thirteen patients(9.7%). The most frequent cause of adverse reactions was arthralgia and/or hyperuricemia, which had occurred in 33 patients(24.6%). Conclusion: In a university hospital in Korea, 6-month short course chemotherapy of 2S(K)HRZ/4HRZ had unnegligible relapses and premature discontinuation. Therefore, change of the regimen might be carefully considered by drug susceptibility results. Close monitoring of patients, retrial of sputum exam and radiologic evaluation during treatment might be required in the endemic area of drug resistant strains like in Korea. Further study about the effect of 6-month short course chemotherapy including pyrazinamide for 6-month might be needed.
Arthralgia
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Drug Therapy
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Follow-Up Studies*
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Humans
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Hyperuricemia
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Korea
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Prospective Studies
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Pyrazinamide
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Recurrence
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Sputum
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Tuberculosis, Pulmonary*
4.Effect of single-herb traditional Chinese medicine for eliminating dampness on metabolism of uric acid.
Meng-Zhen CHU ; Bing ZHANG ; Zhi-Jian LIN ; Xiao-Meng ZHANG ; Yu WANG
China Journal of Chinese Materia Medica 2019;44(7):1485-1490
Through literature review, it was found that there were many literature reports on the effect of single-herb traditional Chinese medicine for lowering uric acid in comparison with other single-herb traditional Chinese medicines. Then what is the relationship between single-herb traditional Chinese medicines for eliminating dampness and uric acid? How do they play a role in lowering uric acid? In this study, traditional Chinese medicines for eliminating dampness in the 2015 Chinese Pharmacopoeia and the innovative textbook of Clinical Chinese Pharmacy for Chinese medicine colleges and universities in the new century were selected as the research objects, and articles about the effect of single-herb traditional Chinese medicines for eliminating dampness in the treatment of hyperuricemia were searched through CNKI, WanFang and VIP. Afterwards, Excel(2016) was used to establish a database, and Excel screening tool was used to extract the classification statistics of its uric acid lowering effect, pharmacodynamic sites, uric acid lowering pathway and mechanism, so as to clarify the relationship between single-herb traditional Chinese medicines for eliminating dampness and uric acid as well as their mechanism on lowering uric acid. The results showed that there were 16 kinds of traditional Chinese medicines with uric acid lowering effect, accounting for 23.88% of the 67 kinds of traditional Chinese medicines for eliminating dampness. Other medicines with the uric acid lowering effect included traditional Chinese medicine extracts and chemical components. The main ways of reducing uric acid included: inhibiting uric acid synthesis and promoting uric acid excretion; mechanism of action was mainly regulating the two key enzymes generated by uric acid and the ion transporters excreted by uric acid. Therefore, it can be seen that this kind of traditional Chinese medicines have a clear effect in reducing uric acid, providing new ideas for drug screening, prescription compatibility and target determination for the treatment of hyperuricemia as well as a theoretical basis for the clinical treatment and research of hyperuricemia.
Drugs, Chinese Herbal
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therapeutic use
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Humans
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Hyperuricemia
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drug therapy
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Medicine, Chinese Traditional
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Uric Acid
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metabolism
5.Study on mechanism of Fangji Huangqi Decoction on hypouricemic effect and renal protection in hyperuricemia mice.
Xing WANG ; Ning XUE ; Li HONG-LEI ; Zhen CHEN ; Yu WAN
China Journal of Chinese Materia Medica 2020;45(21):5248-5255
The aim of this paper was to study the specific mechanism of Fangji Huangqi Decoction(FHT) in decreasing uric acid and improving renal function in mice with hyperuricemia(HUA) induced by potassium oxonate, so as to provide theoretical basis for the research and development of drugs for clinical prevention and treatment of HUA and the modernization of traditional Chinese medicine. Sixty Kunming male mice were randomly divided into 6 groups, with 10 mice in each group, namely normal group, model group(250 mg·kg~(-1) potassium oxonate), FHT high, medium and low-dose groups(10 920, 5 460, and 2 730 mg·kg~(-1)) and positive drug allopurinol group(5 mg·kg~(-1)). Drug administration was given once a day for 7 days. On the 6 th day, mice of each group were kept in metabolic cages, and their urine was collected for 24 hours for determination of uric acid, creatinine, and β2-microglobulin(β2-MG) levels. After 7 days, the animals were sacrificed to determine serum uric acid, creatinine β2-MG and interleukin-1β(IL-1β) levels, and their liver and kidney tissues were collected. The liver tissues were used for subsequent determination of xanthine oxidase(XOD) activity, and the kidney tissues were used for subsequent determination of IL-1β levels, pathological tests and related Western blot experiments. In the cell transfection experiment, the cells were divided into blank group, model group(4.8 mmol·L~(-1) uric acid treatment), FHT administration group(4.8 mmol·L~(-1) uric acid+200 μg·mL~(-1) FHT), leucine-rich repeat kinase 1(LRRK1)-small interfering RNA(siRNA) group(4.8 mmol·L~(-1) uric acid+LRRK1-siRNA transfection) and LRRK1-siRNA+FHT group(4.8 mmol·L~(-1) uric acid+LRRK1-siRNA transfection+200 μg·mL~(-1) FHT). After 24 h incubation, the level of IL-1β in the cell supernatant was detected, and the cellular proteins were extracted and used to determine LRRK1, epidermal growth factor receptor(EGFR), PDZ kinase 1(PDZK1) and nuclear factor-kappa B(NF-κB) protein expression levels. The results showed that, FHT could significantly reduce the uric acid, creatinine and β2-MG levels in serum and β2-MG levels in urine, increase the uric acid and creatinine levels in urine, and improve the renal pathological results of the HUA mice, but showed no effect on liver XOD activity; at the same time, we found that the expression level of IL-1β in serum and kidney, NF-κB, LRRK1 and EGFR protein levels in kidney of HUA mice were significantly increased, and the expression level of PDZK1 protein was significantly decreased, while FHT could significantly improve the abnormal expression of these proteins, and FHT increased protein expression of renal organic anion transporter 1(OAT1), OAT3 and ATP bin-ding transporter G2(ABCG2) in HUA mice, but FHT had no effect on the expression of urate transporter 1(URAT1). In the cell transfection experiment, after transfection of LRRK1-siRNA, the levels of IL-1β, EGFR and NF-κB in supernatant were significantly reduced, and the expression of PDZK1 protein was significantly increased. As compared with the LRRK1-siRNA group, the levels of IL-1β, EGFR, PDZK1 and NF-κB did not change significantly with the additional FHT. This study showed that FHT may regulate the renal uric acid transport system through LRRK1 gene, improve the capacity of uric acid excretion, so as to reduce the level of serum uric acid. At the same time, FHT can not only protect the kidney directly, but also in an indirect manner by reducing the level of uric acid.
Animals
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Drugs, Chinese Herbal
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Hyperuricemia/drug therapy*
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Kidney
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Male
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Mice
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Uric Acid
6.Research progress on anti-hyperuricemia effects and mechanisms of Chinese medicines based on regulation of intestinal flora and metabolites.
Xin-Yue WEN ; Xue-Yang TANG ; Dan HE ; Hai-Chao ZHANG ; Shui-Han ZHANG ; Hong-Liang ZENG
China Journal of Chinese Materia Medica 2021;46(24):6387-6394
Chronical hyperuricemia, a severe metabolic disease characterized by increased serum uric acid, urea nitrogen, and creatinine, has a positive correlation with the risks of gouty arthritis, diabetes, hypertension, and kidney damage. Abnormal purine metabolism and reduced uric acid excretion are the major causes of hyperuricemia, which, thus, points to a potential strategy of preventing from or delaying the progress of hyperuricemia-related diseases and its complications by effectively controlling the serum uric acid level. Increasing evidence has revealed that Chinese medicines alleviate hyperuricemia through regulating intestinal flora, which plays a pivotal role in regulating metabolites, including uric acid level. The disease treatment with traditional Chinese medicine is based on syndrome differentiation, and Chinese medicines often have multiple effects and a wide range of targets. In this review, we summarized the anti-hyperuricemia effects and mechanisms of active compounds in Chinese medicines, single Chinese medicinal herbs, and Chinese medicinal prescriptions in regulating the uric acid level via intestinal flora and metabolites, which will be helpful for further study and application of Chinese medicines in hyperuricemia treatment.
Arthritis, Gouty
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China
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Gastrointestinal Microbiome
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Humans
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Hyperuricemia/drug therapy*
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Uric Acid
7.Changes of serum uric acid levels in patients with chronic hepatitis C after using direct antiviral agents therapy.
Jing LIANG ; Fang LIU ; Ya Ping ZHANG ; Hui Ling XIANG ; Chun Hong LI ; Tao HAN
Chinese Journal of Hepatology 2022;30(1):30-37
Objective: To observe the changes of serum uric acid levels and clinical characteristic in patients with chronic hepatitis C combined with hyperuricemia after direct antiviral agents (DAA) therapy. Methods: A prospective cohort study was used to investigate the risk of hyperuricemia in patients with chronic hepatitis C who received DAA treatment to obtain sustained virological response. The changes and factors influencing serum uric acid levels after 12 weeks of DAA treatment were observed. Comparisons between groups were performed using χ (2) test or Fisher's exact test, analysis of variance, Student's t test, or the non-parametric Mann-Whitney U test. Serum uric acid (SUA) changes, liver and kidney function indexes before and after treatment were compared by repeated measurement and paired t-test. Uric acid reduction was defined as a decrease in SUA from baseline at 12 weeks after treatment. Rates of change in eGFR, aspartate aminotransferase/platelet ratio, alanine aminotransferase and controlled attenuation parameter were defined from baseline (baseline to 12 weeks after treatment). Binary logistic regression analysis was used to compare the risk factors and factors influencing high and low uric acid level. Results: 161 cases with chronic hepatitis C who received DAA treatment were included, of which 19.3% patients were hyperuricemic. eGFR < 60 ml/(min·1.73 m(2)) and body mass index were independent risk factors for hyperuricemia in patients with chronic hepatitis C (eGFR: OR = 0.123, P = 0.002; body mass index: OR = 1.220, P = 0.002). SUA levels was changed significantly before treatment, at the end of treatment and at 12 weeks after treatment (327.96 vs. 320.76 vs. 314.92, F = 3.272, P = 0.042). At 12 weeks after treatment, SUA, liver stiffness, alanine aminotransferase and control attenuation parameters were all significantly lower than baseline (P < 0.05). The rate of increase in eGFR from baseline and the rate of decrease in controlled attenuation parameter during treatment were the factors influencing SUA reduction (eGFR: OR = 5124, P = 0.000; controlled attenuation index: OR = 0.010, P = 0.039). Conclusion: In chronic hepatitis C, reduced eGFR and body mass index are the risk factors for the development of hyperuricemia and a significant reduction in serum uric acid levels after DAA treatment can eradicate the virus.
Antiviral Agents/therapeutic use*
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Hepatitis C, Chronic/drug therapy*
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Humans
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Hyperuricemia/drug therapy*
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Prospective Studies
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Uric Acid
8.Anti-hyperuricemia effect and mechanism of polydatin in mice.
Gao WU ; Han-Bin WU ; Hong JIANG
Acta Pharmaceutica Sinica 2014;49(12):1739-1742
Hyperuricemia mice model was established with uricase inhibitor (potassium oxonate) and uric acids in serum were observed. Polydatin (5, 10, 20 mg · kg(-1)) and benzbromarone (16.7 mg · kg(-1)) were given ig for 7 d in mice. Kidney tissues were used to detect gene contents ofurate anion transporter 1 (URAT1), organic anion transporter 1 (OAT1) and organic anion transporter 3 (OAT3) by real-time-PCR. The results showed that polydatin and benzbromarone can significantly reduce uric acid in blood of hyperuricemia mice (P < 0.05), compared with the model group. URAT1, OAT1 and OAT3 contents of the kidney in hyperuricemia mice changed significantly (P < 0.05), compared with the blank group. Polydatin can significantly inhibit the changing trends in these genes induced by potassium oxonate in a dose-dependent manner, the difference was significant (P < 0.05), compared with the model group. Those indicated that polysatin could reduce the level of the serum uric acid through promoting uric acid excretion.
Animals
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Disease Models, Animal
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Glucosides
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pharmacology
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Hyperuricemia
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drug therapy
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Kidney
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drug effects
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metabolism
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Mice
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Stilbenes
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pharmacology
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Uric Acid
;
blood
9.A Case of Uric Acid Nephropathy as first presentation of Acute Lymphoblastic Leukemia.
Eun Ah LEE ; Yun Sang BAE ; Sang Ho LEE ; Ji Hyock RHEE ; Won Joo MOON ; Chan Hyoung JEONG ; Yoon Shig YANG ; Sung Joo LEE
Korean Journal of Medicine 1998;54(3):437-440
Acute uric acid nephropathy is a kind of acute renal failure and results from uric acid crystal deposition within the collecting ducts and the distal tubules due to rapid increase of serum uric acid concentration. Hyperuricemia can be, in the relation to the underlying physiology, clas sified into the three categories. i.e., increased urate pro duction, decreased uric acid excretion, or a combination of the two. It is most commonly presented in the lympho proliferative or myeloproliferative disorders after effective cytolytic chemotherapy in the form of tumor lysis syn drome. But we have recently experienced a case of a 73 year-old female patient with acute lymphoblastic leuke mia whose first presentation was acute uric acid nephrop athy, spontaneously developed without chemotherapy and so report it with review of related literatures.
Acute Kidney Injury
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Aged
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Drug Therapy
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Female
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Humans
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Hyperuricemia
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Myeloproliferative Disorders
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Physiology
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Precursor Cell Lymphoblastic Leukemia-Lymphoma*
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Uric Acid*
10.Effect of total saponin of dioscorea on uric acid excretion indicators in chronic hyperuricemia rats.
Guang-Liang CHEN ; Song WU ; Sha NA ; Li LI
Chinese Journal of Integrated Traditional and Western Medicine 2014;34(1):75-80
OBJECTIVETo investigate the effect of total saponin of dioscorea (TSD) on uric acid excretion indicators in chronic hyperuricemia rats, and to study the correlation between blood levels of uric acid (SUA) and uric acid excretion indicators.
METHODSTotally 90 SD male rats were randomly divided into 6 groups, i.e., the normal group, the model group, the benzbromarone group (10 mg/kg), the high, middle, and low dose TSD group (300,100, 30 mg/kg, respectively), 15 in each group. The chronic hyperuricemia model was prepared by potassium oxonate (200 mg/kg) and ethambutol (250 mg/kg) except in those of the normal group. All rats were intragastrically administered with corresponding medication once daily for 4 successive weeks since the third week. Contents of SUA and urine uric acid (UUA), serum creatinine (SCr), urine creatinine (UCr), blood urea nitrogen (BUN), and urine volume (UV) were measured on day 14 and day 28 respectively. Uric acid excretion indicators [including the amount of 24 h uric acid excretion (24 h UUA), fractional excretion of uric acid (FEUA), uric acid clearance (CUr), creatinine clearance (CCr), excretion of uric acid per volume of glomerular filtration (EurGF), and ratio of urinary uric acid to creatinine (UUA/UCr)] were calculated. The correlation between SUA and uric acid excretion indicators was analyzed by Pearson correlation analysis.
RESULTScontents of SUA and SCr significantly increased, while the UUA, 24 h UUA, CCr, CUr, FEUA, EurGF, and UUA/UCr significantly decreased in the model group on day 14 and day 28. TSD could dose-dependently reduce the SUA level, significantly increase the UUA, 24 h UUA and CCr, Cur, FEUA, EurGF, showing an approximate effect to that of benzbromarone. But it had no effect on BUN, UCr, UUA/UCr, or UV of hyperuricemia rats. Correlation analysis showed that SUA level was positively correlated with SCr on day 14 and day 28 (r = 0.359, r = 0.306), but negatively correlated with CUr, FEUA, and CCr (r = -0.749 and -0.733; r = -0.669 and -0.646; r = -0.359 and -0.273). SUA level was not correlated with EurGF or UUA/UCr (r = 0.134 and 0.078; r = -0.057 and -0. 065). SUA level was negatively correlated with 24 h UUA on day 14 (r = -0.267), but not correlated with UUA or UCr on day 14. SUA level was negatively correlated with UUA and UCr on day 28 (r = -0.269, r = -0.275), but not correlated with 24 h UUA on day 28.
CONCLUSIONSTSD could promote the excretion of uric acid and significantly increase the excretion of uric acid indicators. SUA was positively correlated with SCr, negatively correlated with Cur, FEUA, and CCr. FEUA and CUr were sensitive indicators of renal excretion of uric acid.
Animals ; Dioscorea ; chemistry ; Hyperuricemia ; drug therapy ; urine ; Male ; Rats ; Rats, Sprague-Dawley ; Saponins ; pharmacology ; therapeutic use ; Uric Acid ; urine