💥 Uric Acid - A Brief Tweetorial
⚡️Why do humans get hyperuricemia whereas most other species do not?
⚡️Does Uric Acid have any function in humans?
⚡️How is Uric Acid eliminated from the body?
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@NephJC
#NephJC
#Tweetorial
⚡️Why do humans get hyperuricemia whereas most other species do not?
⚡️Does Uric Acid have any function in humans?
⚡️How is Uric Acid eliminated from the body?
1/
@NephJC
#NephJC
#Tweetorial
💥What is the source of Uric Acid?
⚡️Uric Acid is the product of purine metabolism
⚡️Diet rich in meat increases Uric Acid load
⚡️This is why Gout was once known as the ‘disease of the affluent’
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⚡️Uric Acid is the product of purine metabolism
⚡️Diet rich in meat increases Uric Acid load
⚡️This is why Gout was once known as the ‘disease of the affluent’
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💥Why do humans develop hyperuricemia (& gout) whereas most other species do not?
It is because of the enzyme:
‼️Uricase
Uricase converts Uric Acid —> Allantoin (a very soluble product) which is eliminated in the urine👇🏽
‼️Humans lack Uricase
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It is because of the enzyme:
‼️Uricase
Uricase converts Uric Acid —> Allantoin (a very soluble product) which is eliminated in the urine👇🏽
‼️Humans lack Uricase
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💥Why did Humans & some primates lose Uricase (silencing of the Uricase gene)?
⚡️This evolutionary phenomenon is not well understood, but various mutations led to loss of Uricase, which led to humans having ⬆️ uric acid levels than most other mammals👇🏽
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⚡️This evolutionary phenomenon is not well understood, but various mutations led to loss of Uricase, which led to humans having ⬆️ uric acid levels than most other mammals👇🏽
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💥What is the purpose of Uric Acid?
⚡️Some species use Uric Acid for nitrogen excretion👇🏽
⚡️Different species use different compounds to excrete nitrogen:
-Urea
-Ammonia
-Uric Acid
⚡️Humans primarily use ‘Urea’ for nitrogen excretion
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⚡️Some species use Uric Acid for nitrogen excretion👇🏽
⚡️Different species use different compounds to excrete nitrogen:
-Urea
-Ammonia
-Uric Acid
⚡️Humans primarily use ‘Urea’ for nitrogen excretion
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💥Why do some species use Urea and others use Uric Acid for nitrogen excretion?
⚡️The main purpose of using Uric Acid for nitrogen excretion is that it allows the organism to excrete nitrogen in a solid state
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⚡️The main purpose of using Uric Acid for nitrogen excretion is that it allows the organism to excrete nitrogen in a solid state
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💥 Excretion of nitrogen in a solid state may be suitable for some species (eg. amphibians) for water conservation👇🏽
⚡️For these species, frank uric acid crystal excretion is not problematic as their urinary tract allows excretion into cloaca/feces
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⚡️For these species, frank uric acid crystal excretion is not problematic as their urinary tract allows excretion into cloaca/feces
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💥If humans don’t use Uric Acid for nitrogen excretion then what is it’s purpose?
A million dollar question!
⚡️From an evolutionary standpoint it is hard to believe that Uric Acid does not have a function given that the Uricase gene was silenced!
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A million dollar question!
⚡️From an evolutionary standpoint it is hard to believe that Uric Acid does not have a function given that the Uricase gene was silenced!
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💥Uric Acid likely has biologic functions in humans though they are not very well understood
💥Studies show that Uric Acid could be:
⚡️An anti-oxidant
⚡️An immune signaling molecule
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💥Studies show that Uric Acid could be:
⚡️An anti-oxidant
⚡️An immune signaling molecule
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💥The bigger issue is that since humans have lost the enzyme Uricase, then how is uric acid safely excreted from the body without crystallizing in the urine?
⚡️1/3rd excreted via GI tract
⚡️2/3rd excreted via the kidney
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⚡️1/3rd excreted via GI tract
⚡️2/3rd excreted via the kidney
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💥Let’s do a poll here:
Uric Acid Nephrolithiasis occurs ‘mainly’ due to:
Uric Acid Nephrolithiasis occurs ‘mainly’ due to:
💥Uric Acid crystallization in the urine (nephrolithiasis) is mainly a due to low urine pH, & not so much due to hyperuricosuria
⚡️Why?
As shown👇🏽
⚡️Uric Acid solubility in urine:
- At a pH of 5.35 is 200 mg/l
- At a pH of 6.5 is 1200 mg/l
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⚡️Why?
As shown👇🏽
⚡️Uric Acid solubility in urine:
- At a pH of 5.35 is 200 mg/l
- At a pH of 6.5 is 1200 mg/l
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Let’s retake the poll:
Uric Acid Nephrolithiasis occurs ‘mainly’ due to:
Uric Acid Nephrolithiasis occurs ‘mainly’ due to:
💥 Therefore, Rx of Uric Acid nephrolithiasis must focus on urine pH manipulation
⚡️What causes ⬇️ urine pH?👇🏽
Causes are listed below but most relevant are:
⚡️Obesity, Insulin resistance & Metabolic Syndrome which is why Uric Acid prevalence is ⬆️
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⚡️What causes ⬇️ urine pH?👇🏽
Causes are listed below but most relevant are:
⚡️Obesity, Insulin resistance & Metabolic Syndrome which is why Uric Acid prevalence is ⬆️
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💥Summary:
⚡️Some species use Uric Acid for nitrogen excretion
⚡️Humans lack the enzyme Uricase & are susceptible to hyperuricemia & it’s associated complications
⚡️Uric Acid Nephrolithiasis is more a function of low urine pH than hyperuricosuria
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⚡️Some species use Uric Acid for nitrogen excretion
⚡️Humans lack the enzyme Uricase & are susceptible to hyperuricemia & it’s associated complications
⚡️Uric Acid Nephrolithiasis is more a function of low urine pH than hyperuricosuria
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💥For more on this topic check out this excellent Tweetorial from @DrFlashHeart
👉🏽
⚡️And join the #NephJC discussion tomorrow
⚡️Thanks to @weddellite for sharing this amazing article that inspired this Tweetorial👇🏽
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👉🏽
⚡️And join the #NephJC discussion tomorrow
⚡️Thanks to @weddellite for sharing this amazing article that inspired this Tweetorial👇🏽
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