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The association between elevated serum uric acid level and an increased risk of renal function decline in a health checkup cohort in China.
Int Urol Nephrol. 2018 Mar; 50(3):517-525.IU

Abstract

PURPOSE

To investigate whether an elevated serum uric acid (SUA) level is an independent risk factor for rapid decline in renal function or new-onset chronic kidney disease (CKD) in a Chinese health checkup population.

METHODS

A cohort study of 6495 Chinese individuals who underwent health checkups with normal estimated glomerular filtration rate (eGFR) at baseline was carried out from May 2011 to April 2016. Examinations included a questionnaire, physical measurements, and blood sampling. The gender-specific quartiles of blood uric acid were used to present baseline descriptive data. Rapid decline of renal function was defined as eGFR loss of > 3 mL/min/1.73 m2/year. New-onset CKD was defined as follow-up eGFR < 60 mL/min/1.73 m2 or positive proteinuria. Multivariable logistic regression was used to assess the relationship between serum uric acid and the following outcomes: rapid decline of renal function, incident CKD, and combined renal outcomes.

RESULTS

During mean follow-up of 52.8 months, 1608 (24.8%) individuals reached combined renal events. Rapid decline in renal function developed in 1506 (23.2%) individuals, and incident CKD was documented in 372 (5.7%) individuals. In a multivariate model adjusted for age, BMI, diabetes, hypertension, alcohol drinking, SBP, total cholesterol, and eGFR, the odds ratio for rapid decline of renal function increased across quartiles of serum uric acid level, reaching a 1.32 (95% CI 1.02-2.97) for the top quartile compared to the lowest quartile (P for trend < 0.001). Meanwhile, higher SUA was also associated with incident CKD in all models. Furthermore, an increased risk of reaching renal outcomes across increasing quartiles of SUA levels appeared to be similar among subgroups stratified according to age, eGFR, and SBP (P < 0.05 in all).

CONCLUSIONS

These findings suggest that higher SUA may predict progressive renal damage and dysfunction in a health checkup population in China.

Authors+Show Affiliations

Department of Health Management, Health Management Research Center of Central South University, The Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, 410013, Hunan Province, China.Zhongguancun Xinzhiyuan Health Management Institute, Beijing, China, 100011.Department of Health Management, Health Management Research Center of Central South University, The Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, 410013, Hunan Province, China. cx_csu@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29094330

Citation

Cao, Xia, et al. "The Association Between Elevated Serum Uric Acid Level and an Increased Risk of Renal Function Decline in a Health Checkup Cohort in China." International Urology and Nephrology, vol. 50, no. 3, 2018, pp. 517-525.
Cao X, Wu L, Chen Z. The association between elevated serum uric acid level and an increased risk of renal function decline in a health checkup cohort in China. Int Urol Nephrol. 2018;50(3):517-525.
Cao, X., Wu, L., & Chen, Z. (2018). The association between elevated serum uric acid level and an increased risk of renal function decline in a health checkup cohort in China. International Urology and Nephrology, 50(3), 517-525. https://doi.org/10.1007/s11255-017-1732-6
Cao X, Wu L, Chen Z. The Association Between Elevated Serum Uric Acid Level and an Increased Risk of Renal Function Decline in a Health Checkup Cohort in China. Int Urol Nephrol. 2018;50(3):517-525. PubMed PMID: 29094330.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between elevated serum uric acid level and an increased risk of renal function decline in a health checkup cohort in China. AU - Cao,Xia, AU - Wu,Liuxin, AU - Chen,Zhiheng, Y1 - 2017/11/01/ PY - 2017/07/03/received PY - 2017/10/23/accepted PY - 2017/11/3/pubmed PY - 2018/9/28/medline PY - 2017/11/3/entrez KW - Chronic kidney disease KW - Cohort KW - Health checkup KW - Kidney function KW - Serum uric acid SP - 517 EP - 525 JF - International urology and nephrology JO - Int Urol Nephrol VL - 50 IS - 3 N2 - PURPOSE: To investigate whether an elevated serum uric acid (SUA) level is an independent risk factor for rapid decline in renal function or new-onset chronic kidney disease (CKD) in a Chinese health checkup population. METHODS: A cohort study of 6495 Chinese individuals who underwent health checkups with normal estimated glomerular filtration rate (eGFR) at baseline was carried out from May 2011 to April 2016. Examinations included a questionnaire, physical measurements, and blood sampling. The gender-specific quartiles of blood uric acid were used to present baseline descriptive data. Rapid decline of renal function was defined as eGFR loss of > 3 mL/min/1.73 m2/year. New-onset CKD was defined as follow-up eGFR < 60 mL/min/1.73 m2 or positive proteinuria. Multivariable logistic regression was used to assess the relationship between serum uric acid and the following outcomes: rapid decline of renal function, incident CKD, and combined renal outcomes. RESULTS: During mean follow-up of 52.8 months, 1608 (24.8%) individuals reached combined renal events. Rapid decline in renal function developed in 1506 (23.2%) individuals, and incident CKD was documented in 372 (5.7%) individuals. In a multivariate model adjusted for age, BMI, diabetes, hypertension, alcohol drinking, SBP, total cholesterol, and eGFR, the odds ratio for rapid decline of renal function increased across quartiles of serum uric acid level, reaching a 1.32 (95% CI 1.02-2.97) for the top quartile compared to the lowest quartile (P for trend < 0.001). Meanwhile, higher SUA was also associated with incident CKD in all models. Furthermore, an increased risk of reaching renal outcomes across increasing quartiles of SUA levels appeared to be similar among subgroups stratified according to age, eGFR, and SBP (P < 0.05 in all). CONCLUSIONS: These findings suggest that higher SUA may predict progressive renal damage and dysfunction in a health checkup population in China. SN - 1573-2584 UR - https://www.unboundmedicine.com/medline/citation/29094330/The_association_between_elevated_serum_uric_acid_level_and_an_increased_risk_of_renal_function_decline_in_a_health_checkup_cohort_in_China_ L2 - https://doi.org/10.1007/s11255-017-1732-6 DB - PRIME DP - Unbound Medicine ER -