title: Serum uric acid is associated with high blood pressure in pediatric hemodialysis patients.
abstract: Serum uric acid (UA) is positively associated with hypertension (HTN). HTN is common in pediatric patients receiving hemodialysis (HD) and peritoneal dialysis (PD). We assessed the relationship between UA and BP in 63 pediatric dialysis patients by measuring pre-treatment UA levels and BP in HD patients and in-center UA levels and blood pressure (BP) in PD patients. UA levels were similar in both groups [6.8 ± 0.2 (HD) vs. 6.5 ± 0.3 (PD), p = 0.6]. Pre-treatment systolic BP percentile was associated with a high UA level [91.9 ± 2.3 (>6.0 mg/dL) vs. 79.3 ± 5.8 mm Hg (≤6.0 mg/dL), p = 0.01] in HD patients only. There was a negative relationship between UA and dialysis vintage (r = -0.31, p = 0.01). In both groups, there was no relationship between UA and Kt/V. In HD patients, fluid overload was unrelated to UA level [4.2 ± 0.6% (≤6.0 mg/dL) vs. 4.3 ± 0.3% (>6.0 mg/dL), p = 0.9]. Moreover, pre-HD treatment systolic BP percentile correlated with UA (beta 0.36, p = 0.02) independent of volume. UA levels were higher in patients receiving anti-hypertensive medications [6.3 ± 0.2 (No Meds] vs 7.0 ± 0.2 (BP Meds) mg/dL,  p= 0.01]. Finally, there was no relationship between serum UA and normalized protein catabolic rate (r = 0.14; p = 0.4). In summary, serum UA impacts BP in pediatric HD patients, independent of volume, nutritional and weight status.
authors.affiliation: Department of Nephrology, Children's National Medical Center, 111 Michigan Avenue NW, Washington, D.C. 20010, USA. dsilvers@cnmc.org
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Silverstein
authors.forename: Poyyapkam R
authors.initials: PR
authors.lastname: Srivaths
authors.forename: Parnell
authors.initials: P
authors.lastname: Mattison
authors.forename: Kiran
authors.initials: K
authors.lastname: Upadhyay
authors.forename: Laurie
authors.initials: L
authors.lastname: Midgley
authors.forename: Asha
authors.initials: A
authors.lastname: Moudgil
authors.forename: Stuart L
authors.initials: SL
authors.lastname: Goldstein
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Feig
mesh_terms: D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight; D002648:Child; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D033461:Hyperuricemia / Q000097:blood / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016014:Linear Models; D008297:Male; D009752:Nutritional Status; D010530:Peritoneal Dialysis / Q000009:adverse effects; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States; D015854:Up-Regulation; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D014527:Uric Acid