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Erschienen in: Journal of Nephrology 4/2015

01.08.2015 | Original Article

Elevated uric acid level as a significant predictor of chronic kidney disease: a cohort study with repeated measurements

verfasst von: Yu-Ching Chou, Jen-Chun Kuan, Tsan Yang, Wan-Yun Chou, Po-Chien Hsieh, Chyi-Huey Bai, San-Lin You, Chien-Hua Chen, Cheng-Yu Wei, Chien-An Sun

Erschienen in: Journal of Nephrology | Ausgabe 4/2015

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Abstract

Background

Cohort studies evaluating increased serum uric acid (SUA) level as a chronic kidney disease (CKD) risk factor have yielded variable results. We aimed to assess the association between the pattern of longitudinal changes in SUA and incident CKD [estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2].

Methods

A population-based cohort study was conducted on 3,605 participants who were followed prospectively for a mean of 5.18 years. The longitudinal changes in SUA were categorized into three subgroups: persistently low, fluctuated (reduced or elevated), and persistently high. The primary outcome of interest was the development of CKD at a follow-up examination. Cox proportional hazards analysis was used to test the hypothesis.

Results

After adjustment for potential confounders, participants with fluctuated SUA with progressively elevated level and persistently high SUA level had significantly higher risk of developing CKD compared to subjects with persistently low SUA level: adjusted hazard ratio (95 % confidence interval) was 2.05 (1.24–3.38) vs. 1.90 (1.34–2.71). This longitudinal relationship was independent of sex, age, body mass index, and hypertension status.

Conclusions

Longitudinally elevated SUA independently predicts the risk of new-onset CKD.
Literatur
1.
Zurück zum Zitat El Nahas AM, Bello AK (2005) Chronic kidney disease: the global challenge. Lancet 365:331–340CrossRef El Nahas AM, Bello AK (2005) Chronic kidney disease: the global challenge. Lancet 365:331–340CrossRef
2.
Zurück zum Zitat Kuo HW, Tsai SS, Tiao MM, Yang CY (2007) Epidemiological features of CKD in Taiwan. Am J Kidney Dis 49:46–55PubMedCrossRef Kuo HW, Tsai SS, Tiao MM, Yang CY (2007) Epidemiological features of CKD in Taiwan. Am J Kidney Dis 49:46–55PubMedCrossRef
3.
Zurück zum Zitat Kang DH, Chen W (2011) Uric acid and chronic kidney disease: new understanding of an old problem. Semin Nephrol 31:447–452PubMedCrossRef Kang DH, Chen W (2011) Uric acid and chronic kidney disease: new understanding of an old problem. Semin Nephrol 31:447–452PubMedCrossRef
4.
Zurück zum Zitat Johnson RJ, Nakaqawa T, Jalal D, Sanchez-Lozada LG, Kang DH, Ritz E (2013) Uric acid and chronic kidney disease: which is chasing which? Nephrol Dial Transplant 28:2221–2228PubMedCentralPubMedCrossRef Johnson RJ, Nakaqawa T, Jalal D, Sanchez-Lozada LG, Kang DH, Ritz E (2013) Uric acid and chronic kidney disease: which is chasing which? Nephrol Dial Transplant 28:2221–2228PubMedCentralPubMedCrossRef
5.
Zurück zum Zitat Hunsicker LG, Adler S, Caggiula A et al (1997) Predictors of the progression of renal disease in the Modification of Diet in Renal Disease Study. Kidney Int 51:1908–1919PubMedCrossRef Hunsicker LG, Adler S, Caggiula A et al (1997) Predictors of the progression of renal disease in the Modification of Diet in Renal Disease Study. Kidney Int 51:1908–1919PubMedCrossRef
6.
Zurück zum Zitat Chonchol M, Shlipak MG, Katz R et al (2007) Relationship of uric acid with progression of kidney disease. Am J Kidney Dis 50:239–247PubMedCrossRef Chonchol M, Shlipak MG, Katz R et al (2007) Relationship of uric acid with progression of kidney disease. Am J Kidney Dis 50:239–247PubMedCrossRef
7.
Zurück zum Zitat Weiner DE, Tighiouart H, Elsayed EF, Griffith JL, Salem DN, Levey AS (2008) Uric acid and incident kidney disease in the community. J Am Soc Nephrol 19:1204–1211PubMedCentralPubMedCrossRef Weiner DE, Tighiouart H, Elsayed EF, Griffith JL, Salem DN, Levey AS (2008) Uric acid and incident kidney disease in the community. J Am Soc Nephrol 19:1204–1211PubMedCentralPubMedCrossRef
8.
Zurück zum Zitat Obermayr RP, Temml C, Gutjahr G, Knechtelsdorfer M, Oberbauer R, Klauser-Braun R (2008) Elevated uric acid increases the risk for kidney disease. J Am Soc Nephrol 19:2407–2413PubMedCentralPubMedCrossRef Obermayr RP, Temml C, Gutjahr G, Knechtelsdorfer M, Oberbauer R, Klauser-Braun R (2008) Elevated uric acid increases the risk for kidney disease. J Am Soc Nephrol 19:2407–2413PubMedCentralPubMedCrossRef
9.
Zurück zum Zitat Yamada T, Fukatsu M, Suzuki S, Wada T, Joh T (2011) Elevated serum uric acid predicts chronic kidney disease. Am J Med Sci 342:461–466PubMedCrossRef Yamada T, Fukatsu M, Suzuki S, Wada T, Joh T (2011) Elevated serum uric acid predicts chronic kidney disease. Am J Med Sci 342:461–466PubMedCrossRef
10.
Zurück zum Zitat Wang S, Shu Z, Tao Q, Yu C, Zhan S, Li L (2011) Uric acid and incident chronic kidney disease in a large health check-up population in Taiwan. Nephrology 16:767–776PubMedCrossRef Wang S, Shu Z, Tao Q, Yu C, Zhan S, Li L (2011) Uric acid and incident chronic kidney disease in a large health check-up population in Taiwan. Nephrology 16:767–776PubMedCrossRef
11.
Zurück zum Zitat Mok Y, Lee SJ, Kim MS, Cui W, Moon YM, Jee SH (2012) Serum uric acid and chronic kidney disease: the Severance cohort study. Nephrol Dial Transplant 27:1831–1835PubMedCrossRef Mok Y, Lee SJ, Kim MS, Cui W, Moon YM, Jee SH (2012) Serum uric acid and chronic kidney disease: the Severance cohort study. Nephrol Dial Transplant 27:1831–1835PubMedCrossRef
12.
Zurück zum Zitat Sedaghat S, Hoorn EJ, van Rooij FJA et al (2013) Serum uric acid and chronic kidney disease: the role of hypertension. PLoS ONE 8:1–8CrossRef Sedaghat S, Hoorn EJ, van Rooij FJA et al (2013) Serum uric acid and chronic kidney disease: the role of hypertension. PLoS ONE 8:1–8CrossRef
13.
Zurück zum Zitat Sturm G, Kollerits B, Neyer U, Ritz E, Kronenberg F (2008) MMKD Study Group. Uric acid as a risk factor for progression of non-diabetic chronic kidney disease? The Mild to Moderate Kidney Disease (MMKD) Study. Exp Gerontol 43:347–352PubMedCrossRef Sturm G, Kollerits B, Neyer U, Ritz E, Kronenberg F (2008) MMKD Study Group. Uric acid as a risk factor for progression of non-diabetic chronic kidney disease? The Mild to Moderate Kidney Disease (MMKD) Study. Exp Gerontol 43:347–352PubMedCrossRef
14.
Zurück zum Zitat See LC, Kuo CF, Chuang FH et al (2008) Serum uric acid is independently associated with metabolic syndrome in subjects with and without a low estimated glomerular filtration rate. J Rheumatol 36:1691–1698CrossRef See LC, Kuo CF, Chuang FH et al (2008) Serum uric acid is independently associated with metabolic syndrome in subjects with and without a low estimated glomerular filtration rate. J Rheumatol 36:1691–1698CrossRef
15.
Zurück zum Zitat Yang T, Chu CH, Bai CH et al (2012) Uric acid level as a risk marker for metabolic syndrome: a Chinese cohort study. Atherosclerosis 220:525–531PubMedCrossRef Yang T, Chu CH, Bai CH et al (2012) Uric acid level as a risk marker for metabolic syndrome: a Chinese cohort study. Atherosclerosis 220:525–531PubMedCrossRef
16.
Zurück zum Zitat Lamb EJ, MacKenzie F, Stevens PE (2009) How should proteinuria be detected and measured? Ann Clin Biochem 46:205–217PubMedCrossRef Lamb EJ, MacKenzie F, Stevens PE (2009) How should proteinuria be detected and measured? Ann Clin Biochem 46:205–217PubMedCrossRef
18.
Zurück zum Zitat Chuang SY, Chen JH, Yeh WT, Wu CC, Pan WH (2012) Hyperuricemia and increased risk of ischemic heart disease in a large Chinese cohort. Int J Cardiol 154:316–321PubMedCrossRef Chuang SY, Chen JH, Yeh WT, Wu CC, Pan WH (2012) Hyperuricemia and increased risk of ischemic heart disease in a large Chinese cohort. Int J Cardiol 154:316–321PubMedCrossRef
19.
Zurück zum Zitat Chobanian AV, Bakris GL, Black HR et al (2003) The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289:2560–2571PubMedCrossRef Chobanian AV, Bakris GL, Black HR et al (2003) The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289:2560–2571PubMedCrossRef
20.
Zurück zum Zitat Deurenberg P, Deurenberg-Yap M, Guricci S (2002) Asians are different from Caucasians and from each other in their body mass index/body fat percent relationship. Obes Rev 3:141–146PubMedCrossRef Deurenberg P, Deurenberg-Yap M, Guricci S (2002) Asians are different from Caucasians and from each other in their body mass index/body fat percent relationship. Obes Rev 3:141–146PubMedCrossRef
21.
Zurück zum Zitat Young JH, Alonso A, Coresh J (2012) Diuretic use, increased serum urate levels, and risk of incident gout in a population-based study of adults with hypertension: the Atherosclerosis Risk in Communities Cohort Study. Arthritis Rheum 64:121–129PubMedCentralPubMedCrossRef Young JH, Alonso A, Coresh J (2012) Diuretic use, increased serum urate levels, and risk of incident gout in a population-based study of adults with hypertension: the Atherosclerosis Risk in Communities Cohort Study. Arthritis Rheum 64:121–129PubMedCentralPubMedCrossRef
22.
Zurück zum Zitat Kang DH, Nakaqawa T, Feng L et al (2002) A role for uric acid in the progression of renal disease. J Am Soc Nephrol 13:2888–2897PubMedCrossRef Kang DH, Nakaqawa T, Feng L et al (2002) A role for uric acid in the progression of renal disease. J Am Soc Nephrol 13:2888–2897PubMedCrossRef
23.
Zurück zum Zitat Siu YP, Leung KT, Tong MK, Kwan TH (2006) Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis 47:51–59PubMedCrossRef Siu YP, Leung KT, Tong MK, Kwan TH (2006) Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis 47:51–59PubMedCrossRef
Metadaten
Titel
Elevated uric acid level as a significant predictor of chronic kidney disease: a cohort study with repeated measurements
verfasst von
Yu-Ching Chou
Jen-Chun Kuan
Tsan Yang
Wan-Yun Chou
Po-Chien Hsieh
Chyi-Huey Bai
San-Lin You
Chien-Hua Chen
Cheng-Yu Wei
Chien-An Sun
Publikationsdatum
01.08.2015
Verlag
Springer International Publishing
Erschienen in
Journal of Nephrology / Ausgabe 4/2015
Print ISSN: 1121-8428
Elektronische ISSN: 1724-6059
DOI
https://doi.org/10.1007/s40620-014-0158-9

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