BACKGROUND: Despite recent evidence, the role of uric acid as a causal factor in the pathogenesis and progression of kidney disease remains controversial, partly because of the inclusion in epidemiologic studies of patients with hypertension, diabetes, and/or proteinuria. STUDY DESIGN: Prospective observational cohort. SETTING & PARTICIPANTS: 900 healthy normotensive adult blood donors (153 women, 747 men) evaluated at baseline and after 5 years. PREDICTOR: Serum uric acid level. OUTCOMES: Decrease in estimated glomerular filtration rate (eGFR) >10 mL/min/1.73 m(2), computed using the Modification of Diet in Renal Disease (MDRD) Study equation, with secondary analyses examining similar decreases using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Cockcroft-Gault equations. RESULTS: During a median follow-up of 59 months, eGFR decreased from 97 +/- 16 to 88 +/- 14 mL/min/1.73 m(2). Higher serum uric acid levels were associated with a greater likelihood of eGFR decrease in both women and men (HR, 1.13 [95% CI, 1.04-1.39] per each 1-mg/dL increase in uric acid level); in multivariable analyses adjusting for age, sex, body mass index, blood glucose level, total cholesterol level, mean blood pressure, urine albumin-creatinine ratio, and serum triglyceride level, the association remained highly significant (HR, 1.28 [95% CI, 1.12-1.48]). Results were similar using different estimating equations and when the association was examined in sex-specific subgroups. LIMITATIONS: Analyses were based on a single baseline uric acid measurement. Women are underrepresented. CONCLUSIONS: In healthy normotensive individuals, serum uric acid level is an independent risk factor for decreased kidney function. Copyright (c) 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
BACKGROUND: Despite recent evidence, the role of uric acid as a causal factor in the pathogenesis and progression of kidney disease remains controversial, partly because of the inclusion in epidemiologic studies of patients with hypertension, diabetes, and/or proteinuria. STUDY DESIGN: Prospective observational cohort. SETTING & PARTICIPANTS: 900 healthy normotensive adult blood donors (153 women, 747 men) evaluated at baseline and after 5 years. PREDICTOR: Serum uric acid level. OUTCOMES: Decrease in estimated glomerular filtration rate (eGFR) >10 mL/min/1.73 m(2), computed using the Modification of Diet in Renal Disease (MDRD) Study equation, with secondary analyses examining similar decreases using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Cockcroft-Gault equations. RESULTS: During a median follow-up of 59 months, eGFR decreased from 97 +/- 16 to 88 +/- 14 mL/min/1.73 m(2). Higher serum uric acid levels were associated with a greater likelihood of eGFR decrease in both women and men (HR, 1.13 [95% CI, 1.04-1.39] per each 1-mg/dL increase in uric acid level); in multivariable analyses adjusting for age, sex, body mass index, blood glucose level, total cholesterol level, mean blood pressure, urine albumin-creatinine ratio, and serum triglyceride level, the association remained highly significant (HR, 1.28 [95% CI, 1.12-1.48]). Results were similar using different estimating equations and when the association was examined in sex-specific subgroups. LIMITATIONS: Analyses were based on a single baseline uric acid measurement. Women are underrepresented. CONCLUSIONS: In healthy normotensive individuals, serum uric acid level is an independent risk factor for decreased kidney function. Copyright (c) 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Authors: Stacey E Jolly; Mihriye Mete; Hong Wang; Jianhui Zhu; Sven O E Ebbesson; V Saroja Voruganti; Anthony G Comuzzie; Barbara V Howard; Jason G Umans Journal: J Clin Hypertens (Greenwich) Date: 2012-01-04 Impact factor: 3.738
Authors: Nicolas Macías; Marian Goicoechea; M S García de Vinuesa; Ursula Verdalles; Jose Luño Journal: Curr Rheumatol Rep Date: 2013-12 Impact factor: 4.592