Fengqin Li1,2, Hui Guo1,2, Jianan Zou1,2, Chensheng Fu1,2, Song Liu3, Jing Xiao4,5, Zhibin Ye6,7. 1. Department of Nephrology, Huadong Hospital Affiliated to Fudan University, No. 221 West Yan'an Road, Shanghai, 200040, People's Republic of China. 2. Shanghai Key Laboratory of Clinical Geriatric Medicine, No. 221 West Yan'an Road, Shanghai, 200040, People's Republic of China. 3. Department of Nephrology, Staten Island University Hospital, Staten Island, USA. 4. Department of Nephrology, Huadong Hospital Affiliated to Fudan University, No. 221 West Yan'an Road, Shanghai, 200040, People's Republic of China. jingxiao13@fudan.edu.cn. 5. Shanghai Key Laboratory of Clinical Geriatric Medicine, No. 221 West Yan'an Road, Shanghai, 200040, People's Republic of China. jingxiao13@fudan.edu.cn. 6. Department of Nephrology, Huadong Hospital Affiliated to Fudan University, No. 221 West Yan'an Road, Shanghai, 200040, People's Republic of China. yezhibin3@126.com. 7. Shanghai Key Laboratory of Clinical Geriatric Medicine, No. 221 West Yan'an Road, Shanghai, 200040, People's Republic of China. yezhibin3@126.com.
Abstract
PURPOSE: Clinical classification of hyperuricemia (HUA) could help to guide therapy of HUA. Studies on the classification of HUA with chronic kidney disease (CKD) are rare. Therefore, we aimed to investigate the classification of HUA with CKD. METHODS: A cross-sectional study of 428 CKD patients was conducted, including 218 HUA patients. By correlation analysis, the association of 24-h urinary uric acid (24-h Uur), uric acid clearance rate (Cur), the urinary uric acid excretion per kilogram of weight per hour (Eur) and fractional excretion of uric acid (FEur) with estimated glomerular filtration rate (eGFR) was analyzed in the HUA and non-HUA groups. According to Eur combined with Cur and the 24-h Uur combined with FEur, HUA with CKD was classified into underexcretion, renal overload, combined and 'normal' types, which were also stratified by CKD stages. RESULTS: According to the Eur and Cur, in early CKD (eGFR ≥ 60 mL/min/1.73 m2), the underexcretion type accounted for 83.75%, and the renal overload type accounted for 2.5%. As the CKD stage increased, the proportion of the underexcretion type increased. According to the 24-h Uur and FEur, in early CKD, the underexcretion type accounted for 53.75%, and the renal overload type accounted for 15%. With increasing CKD stages, the proportion of the 'normal' type increased significantly. CONCLUSION: Different uses of Eur with Cur or 24-h Uur with FEur varied significantly in classifying HUA patients with CKD. Eur + Cur may be more applicable to the classification of HUA patients with CKD, and further research is needed.
PURPOSE: Clinical classification of hyperuricemia (HUA) could help to guide therapy of HUA. Studies on the classification of HUA with chronic kidney disease (CKD) are rare. Therefore, we aimed to investigate the classification of HUA with CKD. METHODS: A cross-sectional study of 428 CKD patients was conducted, including 218 HUA patients. By correlation analysis, the association of 24-h urinary uric acid (24-h Uur), uric acid clearance rate (Cur), the urinary uric acid excretion per kilogram of weight per hour (Eur) and fractional excretion of uric acid (FEur) with estimated glomerular filtration rate (eGFR) was analyzed in the HUA and non-HUA groups. According to Eur combined with Cur and the 24-h Uur combined with FEur, HUA with CKD was classified into underexcretion, renal overload, combined and 'normal' types, which were also stratified by CKD stages. RESULTS: According to the Eur and Cur, in early CKD (eGFR ≥ 60 mL/min/1.73 m2), the underexcretion type accounted for 83.75%, and the renal overload type accounted for 2.5%. As the CKD stage increased, the proportion of the underexcretion type increased. According to the 24-h Uur and FEur, in early CKD, the underexcretion type accounted for 53.75%, and the renal overload type accounted for 15%. With increasing CKD stages, the proportion of the 'normal' type increased significantly. CONCLUSION: Different uses of Eur with Cur or 24-h Uur with FEur varied significantly in classifying HUA patients with CKD. Eur + Cur may be more applicable to the classification of HUA patients with CKD, and further research is needed.