ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2005
Renal hypouricemia is an ominous sign in patients with severe acute respiratory syndrome.
Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Coronavirus-associated kidney outcomes in COVID-19, SARS, and MERS: a meta-analysis and systematic review.Renal failure · 2020Pooled it
- Trial
- Prediction for Risk of Hypouricemia in Hospitalized Patients: A Single-center, Retrospective Cohort Study.Internal medicine (Tokyo, Japan) · 2025Article
- Inflammation Related to Association of Low Uric Acid and Progression to Severe Disease in Patients Hospitalized for Non-Severe Coronavirus Disease 2019.Biomedicines · 2023Article
- Impact of interferon-induced transmembrane protein 3 gene rs12252 polymorphism on COVID-19 mortality.Cytokine · 2022Article
- Uric acid as a prognostic factor and critical marker of COVID-19.Scientific reports · 2021Observational
- The lethal internal face of the coronaviruses: Kidney tropism of the SARS, MERS, and COVID19 viruses.IUBMB life · 2021Review
- Serum uric acid, disease severity and outcomes in COVID-19.Critical care (London, England) · 2021Article
- Serum Uric Acid Concentrations and Risk of Adverse Outcomes in Patients With COVID-19.Frontiers in endocrinology · 2021Article
- Xanthine Oxidase-Induced Inflammatory Responses in Respiratory Epithelial Cells: A Review in Immunopathology of COVID-19.International journal of inflammation · 2021Review
- Successful Treatment of a Critically Ill COVID-19 Patient Using Continuous Renal Replacement Therapy With Enhanced Cytokine Removal and Tocilizumab: A Case Report.Frontiers in medicine · 2021Article
- The Good Treatment, the Bad Virus, and the Ugly Inflammation: Pathophysiology of Kidney Involvement During COVID-19.Frontiers in physiology · 2021Review
- SARS-CoV-2 causes a specific dysfunction of the kidney proximal tubule.Kidney international · 2020Article
- A Comprehensive Review of Manifestations of Novel Coronaviruses in the Context of Deadly COVID-19 Global Pandemic.The American journal of the medical sciences · 2020Review
- Hypouricemia: what the practicing rheumatologist should know about this condition.Clinical rheumatology · 2020Review
- An Inverse Relationship between Hyperuricemia and Mortality in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis.Journal of clinical medicine · 2018Article
- Is the discovery of the novel human betacoronavirus 2c EMC/2012 (HCoV-EMC) the beginning of another SARS-like pandemic?The Journal of infection · 2012Review
- Severe viral infection and the kidney: lessons learned from the H1N1 pandemic.Intensive care medicine · 2011Article
- Clinical and functional characterization of URAT1 variants.PloS one · 2011Article
- Persistent replication of severe acute respiratory syndrome coronavirus in human tubular kidney cells selects for adaptive mutations in the membrane protein.Journal of virology · 2008Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe purpose of this study is to determine the incidence and significance of hypouricemia in patients with severe acute respiratory syndrome (SARS). Pulmonary lesions in patients with SARS are thought to result from proinflammatory cytokine dysregulation. Acute renal failure has been reported in patients with SARS, but whether cytokines can injure renal tubules is unknown.
methodsSixty patients diagnosed with SARS in Taiwan in April 2003 were studied. Patients were identified as hypouricemic when their serum uric acid (UA) level was less than 2.5 mg/dL (<149 micromol/L) within 15 days after fever onset. Urine UA and creatinine levels were available for 43 patients; the serum cytokines interleukin-6 (IL-6), IL-8, and tumor necrosis factor-alpha (TNF-alpha) were measured in 16 patients.
resultsSixteen patients (26.7%) had hypouricemia (UA, 1.68 +/- 0.52 mg/dL [100 +/- 31 micromol/L]). No differences in age, sex, symptoms, vital signs, hemogram, or other biochemistry data existed between the hypouricemic and normouricemic groups. Fractional excretion (FE) of UA (FE UA) in 12 hypouricemic patients was 39.6% +/- 23.4%, significantly greater than that of 31 normouricemic patients (16.4% +/- 11.4%; P < 0.0001). After adjustments for age and sex, high FE UA was significantly associated with the lowest blood oxygenation (P = 0.001; r = -0.624). The number of catastrophic outcomes (endotracheal intubation and/or death) adjusted for older age and sex showed that hypouremic patients had an odds ratio of 10.57 (confidence interval, 2.33 to 47.98; P = 0.002). Kaplan-Meier curves for catastrophic outcome-free results showed significant differences between patients with normouricemia or hypouricemia (P = 0.01). Serum IL-8 levels correlated significantly with FE UA (P < 0.001; r = 0.785) and inversely with serum UA level (P = 0.044; r = -0.509); neither IL-6 nor TNF-alpha level showed such correlations.
conclusionOne fourth of patients with SARS developed hypouricemia, which might result from a defect in renal UA handling and was associated with a high serum IL-8 level. Renal hypouricemia is an ominous sign in patients with SARS.
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