Titre du document / Document title
Hyperuricemia, hypertension, and proteinuria associated with high-
altitude polycythemia
Auteur(s) / Author(s)
JEFFERSON J. Ashley ; ESCUDERO Elizabeth ; HURTADO Maria-Elena ; PANDO
KELLY Jackeline ; SWENSON Erik R. ; WENER Mark H. ; BURNIER Michel ;
MAILLARD Marc ; SCHREINER George F. ; SCHOENE Robert B. ; HURTADO
Abdias ; JOHNSON Richard J. ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
Department of Medicine and Laboratory Medicine, University of
Washington Medical Center, Seattle, WA, ETATS-UNIS
The Carlos Monge Cassinelli Nephrology Center, Hospital Loayza,
Division of Nephrology, University Cayetano Heredia, Lima, PEROU
Division of Hypertension and Vascular Medicine, Centre Hospitalier
Universitaire Vaudois, Lausanne, SUISSE
Scios Inc, Sunnyvale, CA, ETATS-UNIS
Department of Medicine, Baylor College of Medicine, Houston, TX, ETATS-
UNIS
R=E9sum=E9 / Abstract
Chronic exposure to high altitude is associated with the development
of erythrocytosis, proteinuria, and, in some cases, hyperuricemia. We
examined the relationship between high-altitude polycythemia and
proteinuria and hyperuricemia in Cerro de Pasco, Peru (altitude, 4,300
m). We studied 25 adult men with hematocrits less than 65% and 27
subjects with excessive erythrocytosis (EE; hematocrit > 65%) living
in Cerro de Pasco, Peru and compared them with 28 control subjects
living in Lima, Peru (at sea level) and after 48 hours of exposure to
high altitude. Serum urate levels were significantly elevated in
patients with EE at altitude, and gout occurred in 4 of 27 of these
subjects. Urate level strongly correlated with hematocrit (r =3D 0.71; P
< 0.0001). Urate production (24-hour urine urate excretion and urine
urate-creatinine ratio) was increased in this group compared with
those at sea level. Fractional urate excretion was not increased, and
fractional lithium excretion was reduced, in keeping with increased
proximal reabsorption of filtrate. Significantly higher blood
pressures and decreased renin levels in the EE group were in keeping
with increased proximal sodium reabsorption. Serum urate levels
correlated with mean blood pressure (r =3D 0.50; P < 0.0001).
Significant proteinuria was more prevalent in the EE group despite
normal renal function. Hyperuricemia is common in subjects living at
high altitude and associated with EE, hypertension, and proteinuria.
The increase in uric acid levels appears to be caused by increased
urate generation secondary to systemic hypoxia, although a relative
impairment in renal excretion also may contribute.
Revue / Journal Title
American journal of kidney diseases (Am. j. kidney dis.) ISSN
0272-6386
Source / Source
2002, vol. 39, no6, pp. 1135-1142 (36 ref.)
Langue / Language
Anglais
Editeur / Publisher
Elsevier, Orlando, FL, ETATS-UNIS (1981) (Revue)
Mots-cl=E9s anglais / English Keywords
Hemopathy ; Urinary system disease ; Cardiovascular disease ;
Metabolic diseases ; Enzyme ; Oxidoreductases ; Oxygen ; Purine ;
Human ; Hypoxia ; Uric acid ; Hematocrite ; Serum ; Quantitative
analysis ; Urate oxidase ; Chronic ; High altitude ; Polycythemia ;
Association ; Proteinuria ; Hypertension ; Hyperuricemia ;
Mots-cl=E9s fran=E7ais / French Keywords
H=E9mopathie ; Appareil urinaire pathologie ; Appareil circulatoire
pathologie ; M=E9tabolisme pathologie ; Enzyme ; Oxidoreductases ;
Oxyg=E8ne ; Purine ; Homme ; Hypoxie ; Urique acide ; H=E9matocrite ;
S=E9rum ; Analyse quantitative ; Urate oxidase ; Chronique ; Haute
altitude ; Polyglobulie ; Association ; Prot=E9inurie ; Hypertension
art=E9rielle ; Hyperuric=E9mie ;
Mots-cl=E9s espagnols / Spanish Keywords
Hemopat=EDa ; Aparato urinario patolog=EDa ; Aparato circulatorio
patolog=EDa ; Metabolismo patolog=EDa ; Enzima ; Oxidoreductases ;
Ox=EDgeno ; Purina ; Hombre ; Hipoxia ; Urico =E1cido ; Hematocrito ;
Suero ; An=E1lisis cuantitativo ; Urate oxidase ; Cr=F3nico ; Gran
altura ; Policitemia ; Asociaci=F3n ; Proteinuria ; Hipertensi=F3n
arterial ; Hiperuricemia ;
Localisation / Location
INIST-CNRS, Cote INIST : 19098, 35400010824325.0020
Copyright 2007 INIST-CNRS. All rights reserved
Toute reproduction ou diffusion m=EAme partielle, par quelque proc=E9d=E9 ou
sur tout support que ce soit, ne pourra =EAtre faite sans l'accord
pr=E9alable =E9crit de l'INIST-CNRS.
No part of these records may be reproduced of distributed, in any form
or by any means, without the prior written permission of INIST-CNRS.
N=BA notice refdoc (ud4) : 13701434
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