Original InvestigationPathogenesis and Treatment of Kidney DiseaseUric Acid Levels, Kidney Function, and Cardiovascular Mortality in US Adults: National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 1999-2002
Section snippets
Study Population
The present study includes data from NHANES participants 20 years and older surveyed in NHANES III (1988-1994) and continuous NHANES (1999-2002). Participants were excluded if they were pregnant or did not complete both the interview and examination. In NHANES III and NHANES 1999-2002, there were 16,429 and 8,909 participants, respectively, who met the inclusion criteria. In NHANES III, creatinine and uric acid were measured in 15,394 participants and cystatin C was measured in 6,842
Results
During a maximum of 10 (median, 7.7; range, 0.1-10) years of follow-up, there were 2,203 deaths, of which 981 were due to cardiovascular causes. In the pooled sample of NHANES III and NHANES 1999-2002, women with higher uric acid levels were older and more likely to be 65 years and older (Table 1). Women were more likely to have never smoked compared with men (P < 0.001), although differences across uric acid levels were minimal within women or men. On average, women and men with higher uric acid
Discussion
To our knowledge, this is the first study to examine uric acid levels in the US population, based on the new KDIGO-recommended classification system and on 3 renal markers. We found that uric acid levels were associated with eGFR and were highest in persons with the lowest eGFRs. There was a U-shaped association between uric acid levels and cardiovascular morality, although the association of low uric acid levels and mortality was attenuated in adjusted models. Associations of high uric acid
Acknowledgements
Support: Dr Odden is supported by the American Heart Association Western States Affiliate (grant 11CRP7210088) and the National Institute on Aging (grant K01AG039387); no funding agency had any role in the study design; collection, analysis, and interpretation of data; writing of the report; and the decision to submit the report for publication.
Financial Disclosure: The authors declare that they have no other relevant financial interests.
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