Ji Zhang1,2, Min Pan3, JianNa Zhang1,2, XiaoHan You1,2, Dou Li2, Fan Lin2, GuoYuan Lu4. 1. Department of Nephrology, The First Affiliated Hospital of Soochow University, 88 Shizi St., Suzhou, 215006, Jiangsu, People's Republic of China. 2. Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China. 3. Department of Nephrology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China. 4. Department of Nephrology, The First Affiliated Hospital of Soochow University, 88 Shizi St., Suzhou, 215006, Jiangsu, People's Republic of China. lu_guoyuan@hotmail.com.
Abstract
PURPOSE: Accumulating evidence suggests that a relationship exists between serum uric acid (UA) and the progression of chronic kidney disease (CKD), but information regarding idiopathic membranous nephropathy (IMN) is limited. METHODS: Patients with renal biopsy-confirmed diagnosis of IMN between 2009 and 2017 were identified. The demographic and clinical data recorded at the time of renal biopsy were considered the baseline values. The included cases were separated into three groups based on tertiles of the baseline serum UA level, and the relationship between serum UA and poor renal outcome was investigated by receiver operating characteristic (ROC) and time-event analyses. The primary endpoint was poor renal outcome, which was defined as a decrease in the estimated glomerular filtration rate to 50% of the baseline level or progression to end-stage renal disease during the follow-up. RESULTS: Of 989 cases, 572 eligible patients were included. During a median of 18 months of follow-up, 45 (7.9%) patients progressed to the primary endpoint. Both baseline serum UA and time-averaged UA levels could be used for discrimination of renal outcomes, but the difference was not significant (p value = 0.6). Our Cox regression analysis further demonstrated that baseline serum UA was an independent predictor of poor renal outcome in IMN patients, and subgroup analysis revealed a gender difference in the predictive effect of serum UA. CONCLUSIONS: Our study demonstrated that baseline serum UA was an independent predictor of poor renal outcome in patients with IMN, and a gender difference in the predictive effect was observed in our cohort.
PURPOSE: Accumulating evidence suggests that a relationship exists between serum uric acid (UA) and the progression of chronic kidney disease (CKD), but information regarding idiopathic membranous nephropathy (IMN) is limited. METHODS:Patients with renal biopsy-confirmed diagnosis of IMN between 2009 and 2017 were identified. The demographic and clinical data recorded at the time of renal biopsy were considered the baseline values. The included cases were separated into three groups based on tertiles of the baseline serum UA level, and the relationship between serum UA and poor renal outcome was investigated by receiver operating characteristic (ROC) and time-event analyses. The primary endpoint was poor renal outcome, which was defined as a decrease in the estimated glomerular filtration rate to 50% of the baseline level or progression to end-stage renal disease during the follow-up. RESULTS: Of 989 cases, 572 eligible patients were included. During a median of 18 months of follow-up, 45 (7.9%) patients progressed to the primary endpoint. Both baseline serum UA and time-averaged UA levels could be used for discrimination of renal outcomes, but the difference was not significant (p value = 0.6). Our Cox regression analysis further demonstrated that baseline serum UA was an independent predictor of poor renal outcome in IMN patients, and subgroup analysis revealed a gender difference in the predictive effect of serum UA. CONCLUSIONS: Our study demonstrated that baseline serum UA was an independent predictor of poor renal outcome in patients with IMN, and a gender difference in the predictive effect was observed in our cohort.
Authors: Nicola M Tomas; Laurence H Beck; Catherine Meyer-Schwesinger; Barbara Seitz-Polski; Hong Ma; Gunther Zahner; Guillaume Dolla; Elion Hoxha; Udo Helmchen; Anne-Sophie Dabert-Gay; Delphine Debayle; Michael Merchant; Jon Klein; David J Salant; Rolf A K Stahl; Gérard Lambeau Journal: N Engl J Med Date: 2014-11-13 Impact factor: 91.245
Authors: Andrew S Levey; Kai-Uwe Eckardt; Yusuke Tsukamoto; Adeera Levin; Josef Coresh; Jerome Rossert; Dick De Zeeuw; Thomas H Hostetter; Norbert Lameire; Garabed Eknoyan Journal: Kidney Int Date: 2005-06 Impact factor: 10.612
Authors: Laurence H Beck; Ramon G B Bonegio; Gérard Lambeau; David M Beck; David W Powell; Timothy D Cummins; Jon B Klein; David J Salant Journal: N Engl J Med Date: 2009-07-02 Impact factor: 91.245
Authors: Stanford E Mwasongwe; Tibor Fülöp; Ronit Katz; Solomon K Musani; Mario Sims; Adolfo Correa; Michael F Flessner; Bessie A Young Journal: J Clin Hypertens (Greenwich) Date: 2018-02-16 Impact factor: 3.738