title: Hypothesis: Uric acid, nephron number, and the pathogenesis of essential hypertension.
abstract: BACKGROUND
  Essential hypertension affects more than 25% of the world's population. Genetic, physiologic, and epidemiologic studies provide clues to its origins, but a clear understanding has been elusive. Recent experimental and clinical studies have implicated uric acid in the onset of essential hypertension.
  
  
  METHODS
  In a retrospective chart review, we identified 95 children with confirmed, new onset hypertension, and evaluated the cause of hypertension and parental history of hypertension, birth weight, and serum uric acid. In an open-label, cross-over trial we treated 5 children with confirmed essential hypertension with allopurinol as single treatment agent, and screened for change in blood pressure by casual and ambulatory methods. In tissue culture experiments, we evaluated the effect of uric acid on glomerular endothelial cell function.
  
  
  RESULTS
  Elevation of serum uric acid is related to the onset of essential hypertension in children, reduced birth weight, and endothelial dysfunction. Normalization of uric acid appears to ameliorate new onset essential hypertension.
  
  
  CONCLUSIONS
  These findings, combined with animal model data, support the hypothesis that uric acid has a key role in the pathogenesis of early onset essential hypertension, and may unify some of the disparate theories of the origins of essential hypertension.
authors.affiliation: Renal Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. dfeig@bcm.tmc.edu
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Feig
authors.forename: Takahiko
authors.initials: T
authors.lastname: Nakagawa
authors.forename: S Ananth
authors.initials: SA
authors.lastname: Karumanchi
authors.forename: William J
authors.initials: WJ
authors.lastname: Oliver
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Kang
authors.forename: Jennifer
authors.initials: J
authors.lastname: Finch
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Johnson
mesh_terms: D000818:Animals; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008954:Models, Biological; D009399:Nephrons / Q000002:abnormalities*; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid