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Uric acid and incident chronic kidney disease in dyslipidemic individuals.
Curr Med Res Opin. 2018 07; 34(7):1193-1199.CM

Abstract

BACKGROUND

Elevated uric acid (UA) is a recognized risk factor for chronic kidney disease (CKD). This study aimed to investigate whether this association exists in dyslipidemic patients receiving multifactorial treatment.

METHODS

An observational study conducted in Greece including 1,269 dyslipidemic individuals followed-up in a lipid clinic for ≥3 years. Estimated glomerular filtration rate (eGFR) was calculated by CKD-EPI equation and CKD was defined as ≤60 mL/min/1.73 m2. The correlation was assessed between UA levels and the CKD risk after adjusting for potential confounding factors, after defining the following UA quartiles: Q1: < 4, Q2: 4-5, Q3: 5-6, and Q4: > 6 mg/dL.

RESULTS

After excluding patients with baseline eGFR <60 mL/min/1.73 m2, gout and those taking UA-lowering drugs, 1,095 individuals were eligible; of those, 91% and 69% were treated with statins and anti-hypertensive drugs, respectively. During their follow-up (6 years; IQR = 4-10), 11.9% of the subjects developed CKD, whereas the median annual eGFR decline was 0.69 mL/min/1.73 m2 (IQR = 0.45-2.33). Multivariate analysis showed that baseline UA levels (HR = 1.26; 95% CI = 1.09-1.45, p = .001), female gender (HR = 1.74; 95% CI = 1.14-2.65, p = .01), age (HR = 1.10; 95% CI = 1.07-1.12, p < .001), diabetes (HR = 1.67; 95% CI = 1.05-2.65, p = .03), cardiovascular disease (HR = 1.62; 95% CI = 1.02-2.58, p = .04), decreased baseline renal function (eGFR <90 mL/min/1.73 m2) (HR = 2.38; 95% CI = 1.14-4.81, p = .02), and low-density lipoprotein cholesterol reduction (HR = 0.995; 95% CI = 0.991-0.998, p = .01) were associated with incident CKD. Additionally, patients with UA ≥6 mg/dL exhibited a higher risk of incident CKD compared with those in the lowest UA quartile (HR = 2.01; 95% CI = 1.11-3.65, p = .02).

CONCLUSION

Higher UA levels are correlated with a higher risk of incident CKD in dyslipidemic individuals taking multifactorial treatment.

Authors+Show Affiliations

a Department of Internal Medicine, School of Medicine , University of Ioannina , Ioannina , Greece.a Department of Internal Medicine, School of Medicine , University of Ioannina , Ioannina , Greece.a Department of Internal Medicine, School of Medicine , University of Ioannina , Ioannina , Greece.b Department of Nephrology , University Hospital of Ioannina , Ioannina , Greece.a Department of Internal Medicine, School of Medicine , University of Ioannina , Ioannina , Greece.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

28836857

Citation

Barkas, Fotios, et al. "Uric Acid and Incident Chronic Kidney Disease in Dyslipidemic Individuals." Current Medical Research and Opinion, vol. 34, no. 7, 2018, pp. 1193-1199.
Barkas F, Elisaf M, Liberopoulos E, et al. Uric acid and incident chronic kidney disease in dyslipidemic individuals. Curr Med Res Opin. 2018;34(7):1193-1199.
Barkas, F., Elisaf, M., Liberopoulos, E., Kalaitzidis, R., & Liamis, G. (2018). Uric acid and incident chronic kidney disease in dyslipidemic individuals. Current Medical Research and Opinion, 34(7), 1193-1199. https://doi.org/10.1080/03007995.2017.1372157
Barkas F, et al. Uric Acid and Incident Chronic Kidney Disease in Dyslipidemic Individuals. Curr Med Res Opin. 2018;34(7):1193-1199. PubMed PMID: 28836857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Uric acid and incident chronic kidney disease in dyslipidemic individuals. AU - Barkas,Fotios, AU - Elisaf,Moses, AU - Liberopoulos,Evangelos, AU - Kalaitzidis,Rigas, AU - Liamis,George, Y1 - 2017/09/21/ PY - 2017/8/25/pubmed PY - 2019/9/24/medline PY - 2017/8/25/entrez KW - Uric acid KW - chronic kidney disease KW - hyperuricemia KW - incidence KW - risk KW - statins SP - 1193 EP - 1199 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 34 IS - 7 N2 - BACKGROUND: Elevated uric acid (UA) is a recognized risk factor for chronic kidney disease (CKD). This study aimed to investigate whether this association exists in dyslipidemic patients receiving multifactorial treatment. METHODS: An observational study conducted in Greece including 1,269 dyslipidemic individuals followed-up in a lipid clinic for ≥3 years. Estimated glomerular filtration rate (eGFR) was calculated by CKD-EPI equation and CKD was defined as ≤60 mL/min/1.73 m2. The correlation was assessed between UA levels and the CKD risk after adjusting for potential confounding factors, after defining the following UA quartiles: Q1: < 4, Q2: 4-5, Q3: 5-6, and Q4: > 6 mg/dL. RESULTS: After excluding patients with baseline eGFR <60 mL/min/1.73 m2, gout and those taking UA-lowering drugs, 1,095 individuals were eligible; of those, 91% and 69% were treated with statins and anti-hypertensive drugs, respectively. During their follow-up (6 years; IQR = 4-10), 11.9% of the subjects developed CKD, whereas the median annual eGFR decline was 0.69 mL/min/1.73 m2 (IQR = 0.45-2.33). Multivariate analysis showed that baseline UA levels (HR = 1.26; 95% CI = 1.09-1.45, p = .001), female gender (HR = 1.74; 95% CI = 1.14-2.65, p = .01), age (HR = 1.10; 95% CI = 1.07-1.12, p < .001), diabetes (HR = 1.67; 95% CI = 1.05-2.65, p = .03), cardiovascular disease (HR = 1.62; 95% CI = 1.02-2.58, p = .04), decreased baseline renal function (eGFR <90 mL/min/1.73 m2) (HR = 2.38; 95% CI = 1.14-4.81, p = .02), and low-density lipoprotein cholesterol reduction (HR = 0.995; 95% CI = 0.991-0.998, p = .01) were associated with incident CKD. Additionally, patients with UA ≥6 mg/dL exhibited a higher risk of incident CKD compared with those in the lowest UA quartile (HR = 2.01; 95% CI = 1.11-3.65, p = .02). CONCLUSION: Higher UA levels are correlated with a higher risk of incident CKD in dyslipidemic individuals taking multifactorial treatment. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/28836857/Uric_acid_and_incident_chronic_kidney_disease_in_dyslipidemic_individuals_ L2 - https://www.tandfonline.com/doi/full/10.1080/03007995.2017.1372157 DB - PRIME DP - Unbound Medicine ER -