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Serum uric acid and the incidence of CKD and hypertension.
Clin Exp Nephrol. 2015 Dec; 19(6):1127-34.CE

Abstract

BACKGROUND

Uric acid (UA) levels correlate positively with the prevalence of chronic kidney disease (CKD) and/or hypertension. We tested the hypothesis that UA may also have a link to a new incidence of CKD and hypertension.

METHODS

Study design is a cohort study and the predictor is UA levels. Of the 15,470 screened cases, 8223 participants without CKD were eligible for the analysis of the incidence of CKD. Among these CKD candidates, 7569 participants were eligible for the analysis of the new development of hypertension. The observation period was 4 years.

RESULTS

Relationship of UA with new cases of CKD. Higher UA levels had a closer association with the new development of CKD; 1.1 % (UA < 5 mg/dL), 1.5 % (5.0-5.9 mg/dL), 1.7 % (6.0-6.9 mg/dL), and 3.4 % (≧7 mg/dL), respectively (p < 0.001 by the Chi-square test). Cox proportional hazard analysis showed that the estimates of the CKD development were eGFR [Hazard Ratio (HR) 0.816, 95 % confidence intervals (CI) 0.791-0.840] and male gender (HR 0.562, 95 % CI 0.322-0.982). UA levels and new development of hypertension. Higher UA levels had a closer association with the new development of hypertension; 5.0 % (UA < 5 mg/dL), 8.9 % (5.0-5.9 mg/dL), 10.6 % (6.0-6.9 mg/dL), and 11.8 % (≧7 mg/dL), respectively (p < 0.001 by the Chi-square test). Cox proportional hazard analysis showed that the estimates of the hypertension development were BMI (HR 1.190, 95 % CI 1.155-1.226), age (HR 1.021, 95 % CI 1.010-1.032), HDL-cholesterol (HR 1.013, 95 % CI 1.007-1.019), male gender (HR 1.791, 95 % CI 1.338-2.395), UA level (HR 1.112, 95 % CI 1.024-1.207), and eGFR (HR 1008, 95 % CI 1.002-1.013). Furthermore, the logistic analysis showed that the odds ratio (OR) to estimate hypertension in the high UA group (UA ≧ 7 mg/dL; OR 1.33, 95 % CI 1.01-1.80) was greater than that in the low UA group (UA < 5 mg/dL). Kaplan-Meier analysis also confirmed the finding that the higher the UA levels the greater the hypertension development (p < 0.001 by the Log-rank test and Cox proportional hazard analysis).

CONCLUSION

High UA levels are associated with the new development of hypertension, but not with the incidence of CKD.

Authors+Show Affiliations

Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan. kuriyamas218@yahoo.co.jp.Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.Department of Pathophysiology and Therapy in Chronic Kidney Disease, Jikei University School of Medicine, Tokyo, Japan.Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

25967597

Citation

Kuriyama, Satoru, et al. "Serum Uric Acid and the Incidence of CKD and Hypertension." Clinical and Experimental Nephrology, vol. 19, no. 6, 2015, pp. 1127-34.
Kuriyama S, Maruyama Y, Nishio S, et al. Serum uric acid and the incidence of CKD and hypertension. Clin Exp Nephrol. 2015;19(6):1127-34.
Kuriyama, S., Maruyama, Y., Nishio, S., Takahashi, Y., Kidoguchi, S., Kobayashi, C., Takahashi, D., Sugano, N., Hosoya, T., & Yokoo, T. (2015). Serum uric acid and the incidence of CKD and hypertension. Clinical and Experimental Nephrology, 19(6), 1127-34. https://doi.org/10.1007/s10157-015-1120-4
Kuriyama S, et al. Serum Uric Acid and the Incidence of CKD and Hypertension. Clin Exp Nephrol. 2015;19(6):1127-34. PubMed PMID: 25967597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum uric acid and the incidence of CKD and hypertension. AU - Kuriyama,Satoru, AU - Maruyama,Yukio, AU - Nishio,Shinichiro, AU - Takahashi,Yasuhito, AU - Kidoguchi,Satoshi, AU - Kobayashi,Chisa, AU - Takahashi,Daisuke, AU - Sugano,Naoki, AU - Hosoya,Tatsuo, AU - Yokoo,Takashi, Y1 - 2015/05/13/ PY - 2014/12/08/received PY - 2015/04/29/accepted PY - 2015/5/14/entrez PY - 2015/5/15/pubmed PY - 2016/9/20/medline KW - CKD KW - Estimated glomerular filtration rate KW - Hypertension KW - Uric acid SP - 1127 EP - 34 JF - Clinical and experimental nephrology JO - Clin Exp Nephrol VL - 19 IS - 6 N2 - BACKGROUND: Uric acid (UA) levels correlate positively with the prevalence of chronic kidney disease (CKD) and/or hypertension. We tested the hypothesis that UA may also have a link to a new incidence of CKD and hypertension. METHODS: Study design is a cohort study and the predictor is UA levels. Of the 15,470 screened cases, 8223 participants without CKD were eligible for the analysis of the incidence of CKD. Among these CKD candidates, 7569 participants were eligible for the analysis of the new development of hypertension. The observation period was 4 years. RESULTS: Relationship of UA with new cases of CKD. Higher UA levels had a closer association with the new development of CKD; 1.1 % (UA < 5 mg/dL), 1.5 % (5.0-5.9 mg/dL), 1.7 % (6.0-6.9 mg/dL), and 3.4 % (≧7 mg/dL), respectively (p < 0.001 by the Chi-square test). Cox proportional hazard analysis showed that the estimates of the CKD development were eGFR [Hazard Ratio (HR) 0.816, 95 % confidence intervals (CI) 0.791-0.840] and male gender (HR 0.562, 95 % CI 0.322-0.982). UA levels and new development of hypertension. Higher UA levels had a closer association with the new development of hypertension; 5.0 % (UA < 5 mg/dL), 8.9 % (5.0-5.9 mg/dL), 10.6 % (6.0-6.9 mg/dL), and 11.8 % (≧7 mg/dL), respectively (p < 0.001 by the Chi-square test). Cox proportional hazard analysis showed that the estimates of the hypertension development were BMI (HR 1.190, 95 % CI 1.155-1.226), age (HR 1.021, 95 % CI 1.010-1.032), HDL-cholesterol (HR 1.013, 95 % CI 1.007-1.019), male gender (HR 1.791, 95 % CI 1.338-2.395), UA level (HR 1.112, 95 % CI 1.024-1.207), and eGFR (HR 1008, 95 % CI 1.002-1.013). Furthermore, the logistic analysis showed that the odds ratio (OR) to estimate hypertension in the high UA group (UA ≧ 7 mg/dL; OR 1.33, 95 % CI 1.01-1.80) was greater than that in the low UA group (UA < 5 mg/dL). Kaplan-Meier analysis also confirmed the finding that the higher the UA levels the greater the hypertension development (p < 0.001 by the Log-rank test and Cox proportional hazard analysis). CONCLUSION: High UA levels are associated with the new development of hypertension, but not with the incidence of CKD. SN - 1437-7799 UR - https://www.unboundmedicine.com/medline/citation/25967597/Serum_uric_acid_and_the_incidence_of_CKD_and_hypertension_ L2 - https://dx.doi.org/10.1007/s10157-015-1120-4 DB - PRIME DP - Unbound Medicine ER -