Fangfang Zhou1,2, Geping Yu3, Guoyu Wang4, Yunzi Liu1,2, Liwen Zhang1,2, Weiming Wang5,6, Nan Chen1,2. 1. Institute of Nephrology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China. 2. Department of Nephrology, RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China. 3. Department of Nephrology, Tonglu County First People's Hospital, Hangzhou, 311500, China. 4. Information Section, Tonglu County First People's Hospital, Hangzhou, 311500, China. 5. Institute of Nephrology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China. wwm11120@rjh.com.cn. 6. Department of Nephrology, RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China. wwm11120@rjh.com.cn.
Abstract
BACKGROUND: Epidemiological studies suggest that higher serum uric acid (SUA) level is significantly associated with kidney disease development. However, it remains debatable whether higher SUA is independently associated with new-onset kidney disease and rapid eGFR decline in individuals with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 and negative proteinuria. METHODS: This was a large, single-center, retrospective 6-year cohort study at People's Hospital of Tonglu County, Zhejiang, from 2001 to 2006. We enrolled 10,677 participants (19-92 years) with eGFR ≥ 60 mL/min/1.73 m2 and without dipstick proteinuria at baseline. The association between SUA change and the occurrence of renal outcomes and annual eGFR decline were evaluated using Cox models with adjustment for confounders. RESULTS: Higher quartiles (2.51%) of SUA levels were associated with greater prevalence of kidney disease compared with quartile 1 (0.52%), 2 (1.13%) and 3 (1.76%), respectively. In addition, greater baseline SUA levels [OR (95% CI) 3.29(1.68-6.45), p < 0.001] and increased SUA [1.36(1.23-1.50), p < 0.001] were all associated with greater odds of renal disease progression when comparing the 4th quartile of annual eGFR decline rate with the 1st quartile. In addition, both of higher baseline SUA levels and increased SUA change were the risk factors of rapid annual eGFR decline along with male gender, lower albumin, hematocrit and creatinine levels, higher hemoglobin levels and hyperlipidemia after multivariable adjustments when compared with each quartile group. CONCLUSIONS: Increasing SUA were independent risk factor for the prevalent of kidney disease and rapid eGFR decline and reduced SUA over time could abate kidney disease development in a Chinese community.
BACKGROUND: Epidemiological studies suggest that higher serum uric acid (SUA) level is significantly associated with kidney disease development. However, it remains debatable whether higher SUA is independently associated with new-onset kidney disease and rapid eGFR decline in individuals with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 and negative proteinuria. METHODS: This was a large, single-center, retrospective 6-year cohort study at People's Hospital of Tonglu County, Zhejiang, from 2001 to 2006. We enrolled 10,677 participants (19-92 years) with eGFR ≥ 60 mL/min/1.73 m2 and without dipstick proteinuria at baseline. The association between SUA change and the occurrence of renal outcomes and annual eGFR decline were evaluated using Cox models with adjustment for confounders. RESULTS: Higher quartiles (2.51%) of SUA levels were associated with greater prevalence of kidney disease compared with quartile 1 (0.52%), 2 (1.13%) and 3 (1.76%), respectively. In addition, greater baseline SUA levels [OR (95% CI) 3.29(1.68-6.45), p < 0.001] and increased SUA [1.36(1.23-1.50), p < 0.001] were all associated with greater odds of renal disease progression when comparing the 4th quartile of annual eGFR decline rate with the 1st quartile. In addition, both of higher baseline SUA levels and increased SUA change were the risk factors of rapid annual eGFR decline along with male gender, lower albumin, hematocrit and creatinine levels, higher hemoglobin levels and hyperlipidemia after multivariable adjustments when compared with each quartile group. CONCLUSIONS: Increasing SUA were independent risk factor for the prevalent of kidney disease and rapid eGFR decline and reduced SUA over time could abate kidney disease development in a Chinese community.
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