Predictive value of uric acid in gastric mucosal damage in hemodialysis patients.
OBJECTIVE
Uric acid, which has an antioxidant effect, is present at very high serum levels in hemodialysis patients, but its effect has not yet been clarified. In this study we investigated whether or not serum uric acid levels could be associated with gastric mucosal damage in hemodialysis patients.


METHODS
We performed endoscopy in 53 patients who were on dialysis for more than two months and determined the relationship between serum uric acid levels, clinical features and gastric mucosal damage.


RESULTS
Of 53 patients, gastroduodenal ulcer was found in 13 patients (Ulcer group), gastritis lesions in 25 patients (Gastritis group) and no pathological findings in 15 patients (Normal group). Serum uric acid levels before the dialytic session were remarkably higher in the Ulcer group than in the Normal (P < 0.01) or Gastritis group (P < 0.05). There was also a significant difference between the Gastritis and Normal groups in the serum uric acid levels (P < 0.05). Alcohol intake and noncompliance resulted in a significant increase in both gastric mucosal damage (P = 0.009 and P = 0.010) and serum uric acid levels (P < 0.05 and P < 0.01). Serum uric acid levels were markedly decreased after treatment with a proton pump inhibitor or H2 blocker.


CONCLUSIONS
In hemodialysis patients alcohol intake and noncompliance contribute to the increase in serum uric acid levels and gastric mucosal damage, and serum uric acid levels have predictive values in gastric mucosal damage.
Tsukada
Katsuhiko
K
Department of First Surgery, Gunma University School of Medicine, 3-39-22 Showamachi, Maebashi, 371-8511, Japan.
Hasegawa
Tadashi
T
Miyazaki
Tatsuya
T
Katoh
Hiroyuki
H
Yoshikawa
Minako
M
Masuda
Norihiro
N
Ojima
Hitoshi
H
Tajima
Kohei
K
Fukai
Yasuyuki
Y
Nakajima
Masanobu
M
Kamiyama
Youichi
Y
Kuwano
Hiroyuki
H
Yamamoto
Yorihiro
Y
Tsukada
Osamu
O
D000368:Aged; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D014527:Uric Acid / Q000097:blood*
D014527:Uric Acid; D003404:Creatinine; D002118:Calcium