Pediatric Nephrology

, Volume 26, Issue 7, pp 1123–1128

Serum uric acid is associated with high blood pressure in pediatric hemodialysis patients

  • Douglas M. Silverstein
  • Poyyapkam R. Srivaths
  • Parnell Mattison
  • Kiran Upadhyay
  • Laurie Midgley
  • Asha Moudgil
  • Stuart L. Goldstein
  • Daniel I. Feig
Original Article

DOI: 10.1007/s00467-011-1875-0

Cite this article as:
Silverstein, D.M., Srivaths, P.R., Mattison, P. et al. Pediatr Nephrol (2011) 26: 1123. doi:10.1007/s00467-011-1875-0

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.

Keywords

Uric acidHypertensionEnd-stage renal disease

Copyright information

© IPNA 2011

Authors and Affiliations

  • Douglas M. Silverstein
    • 1
  • Poyyapkam R. Srivaths
    • 2
  • Parnell Mattison
    • 1
  • Kiran Upadhyay
    • 1
  • Laurie Midgley
    • 1
  • Asha Moudgil
    • 1
  • Stuart L. Goldstein
    • 3
  • Daniel I. Feig
    • 2
  1. 1.Department of NephrologyChildren’s National Medical CenterWashingtonUSA
  2. 2.Departments of Pediatrics, Divisions of NephrologyBaylor College of MedicineHoustonUSA
  3. 3.Cincinnati Children’s Hospital Medical CenterCincinnatiUSA