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Uric acid level has a U-shaped association with loss of kidney function in healthy people: a prospective cohort study.

Kanda E, Muneyuki T, Kanno Y, Suwa K, Nakajima K - PLoS ONE (2015)

Bottom Line: The analysis was conducted on 4188 subjects followed up for at least 3 years, 3102 for 6 years and 1052 for 9 years.The outcome event was incident CKD or the decrease in eGFR by more than 25% in three years.Multivariate statistical models were adjusted for the baseline characteristics.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Tokyo Kyosai Hospital, Meguro, Tokyo, Japan; Center for life science and bioethics, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan.

ABSTRACT

Background: The relationship between hyperuricemia and chronic kidney disease (CKD) has been found in various observational studies. Although hypouricemia is associated with cardiovascular events, it has not been established as a risk factor for CKD. We investigated the relationship between serum uric acid level and the loss of kidney function and incident CKD in healthy people.

Materials and methods: Healthy people were enrolled in this community-based prospective cohort study, the Saitama Cardiometabolic Disease and Organ Impairment Study, Japan. The analysis was conducted on 4188 subjects followed up for at least 3 years, 3102 for 6 years and 1052 for 9 years. Their data including glomerular filtration rate (eGFR) decline were examined every three years. The outcome event was incident CKD or the decrease in eGFR by more than 25% in three years. Multivariate statistical models were adjusted for the baseline characteristics.

Results: The following data was obtained: mean ± SD age, male, 39.6 ± 10.4 years, female 38.4 ± 10.8 years; eGFR, male, 81.9 ± 16.4 ml/min/1.73 m2, female, 82.1 ± 17.5 ml/min/1.73 m2; serum uric acid level, male, 5.8 ± 1.2 mg/dl, female, 4.1 ± 0.9 mg/dl. Both low and high serum uric acid levels were associated with the outcome and eGFR decline in males (multivariate logistic additional additive models, linear p = 0.0001, spline p = 0.043; generalized additive models, linear p = 0.0001, spline p = 0.012). In subjects with low serum uric acid levels (male, <5 mg/dl; female, <3.6 mg/dl), multivariate linear mixed models showed that low serum uric acid levels were associated with eGFR decline in a time-dependent manner (male, p = 0.0001; female, p = 0.045).

Conclusion: This study showed that low as well as high levels of uric acid are associated with the loss of kidney function. Hypouricemia is a candidate predictor of kidney function decline in healthy people.

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Related in: MedlinePlus

Effect of serum uric acid level on loss of kidney function.The high risk of loss of kidney function was observed in males with low or high serum uric acid levels, but not in females. The curves from logistic additive models with spline show a pattern indicating the effect of serum uric acid level on the likelihood of loss of kidney function with 95% confidence interval: male, linear p = 0.0001, spline p = 0.043; female, linear p = 0.18, spline p = 0.68. The models are adjusted for baseline characteristics. Abbreviations: Effect, effect of serum uric acid level on the likelihood of loss of kidney function.
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pone.0118031.g002: Effect of serum uric acid level on loss of kidney function.The high risk of loss of kidney function was observed in males with low or high serum uric acid levels, but not in females. The curves from logistic additive models with spline show a pattern indicating the effect of serum uric acid level on the likelihood of loss of kidney function with 95% confidence interval: male, linear p = 0.0001, spline p = 0.043; female, linear p = 0.18, spline p = 0.68. The models are adjusted for baseline characteristics. Abbreviations: Effect, effect of serum uric acid level on the likelihood of loss of kidney function.

Mentions: A large number of males with incident CKD and more than 25% decrease in eGFR were observed in groups 4 and 1, respectively (Table 1). Moreover, there was no significant difference in the incidence of outcome events. In females, there was also no significant difference in the incidence of outcome events (Table 2). Logistic additive models showed that both high and low serum uric acid levels affected the likelihood of the outcome events than intermediate levels in males, and that serum uric acid level was not associated with the outcome events in females (Fig. 2).


Uric acid level has a U-shaped association with loss of kidney function in healthy people: a prospective cohort study.

Kanda E, Muneyuki T, Kanno Y, Suwa K, Nakajima K - PLoS ONE (2015)

Effect of serum uric acid level on loss of kidney function.The high risk of loss of kidney function was observed in males with low or high serum uric acid levels, but not in females. The curves from logistic additive models with spline show a pattern indicating the effect of serum uric acid level on the likelihood of loss of kidney function with 95% confidence interval: male, linear p = 0.0001, spline p = 0.043; female, linear p = 0.18, spline p = 0.68. The models are adjusted for baseline characteristics. Abbreviations: Effect, effect of serum uric acid level on the likelihood of loss of kidney function.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4320097&req=5

pone.0118031.g002: Effect of serum uric acid level on loss of kidney function.The high risk of loss of kidney function was observed in males with low or high serum uric acid levels, but not in females. The curves from logistic additive models with spline show a pattern indicating the effect of serum uric acid level on the likelihood of loss of kidney function with 95% confidence interval: male, linear p = 0.0001, spline p = 0.043; female, linear p = 0.18, spline p = 0.68. The models are adjusted for baseline characteristics. Abbreviations: Effect, effect of serum uric acid level on the likelihood of loss of kidney function.
Mentions: A large number of males with incident CKD and more than 25% decrease in eGFR were observed in groups 4 and 1, respectively (Table 1). Moreover, there was no significant difference in the incidence of outcome events. In females, there was also no significant difference in the incidence of outcome events (Table 2). Logistic additive models showed that both high and low serum uric acid levels affected the likelihood of the outcome events than intermediate levels in males, and that serum uric acid level was not associated with the outcome events in females (Fig. 2).

Bottom Line: The analysis was conducted on 4188 subjects followed up for at least 3 years, 3102 for 6 years and 1052 for 9 years.The outcome event was incident CKD or the decrease in eGFR by more than 25% in three years.Multivariate statistical models were adjusted for the baseline characteristics.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Tokyo Kyosai Hospital, Meguro, Tokyo, Japan; Center for life science and bioethics, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan.

ABSTRACT

Background: The relationship between hyperuricemia and chronic kidney disease (CKD) has been found in various observational studies. Although hypouricemia is associated with cardiovascular events, it has not been established as a risk factor for CKD. We investigated the relationship between serum uric acid level and the loss of kidney function and incident CKD in healthy people.

Materials and methods: Healthy people were enrolled in this community-based prospective cohort study, the Saitama Cardiometabolic Disease and Organ Impairment Study, Japan. The analysis was conducted on 4188 subjects followed up for at least 3 years, 3102 for 6 years and 1052 for 9 years. Their data including glomerular filtration rate (eGFR) decline were examined every three years. The outcome event was incident CKD or the decrease in eGFR by more than 25% in three years. Multivariate statistical models were adjusted for the baseline characteristics.

Results: The following data was obtained: mean ± SD age, male, 39.6 ± 10.4 years, female 38.4 ± 10.8 years; eGFR, male, 81.9 ± 16.4 ml/min/1.73 m2, female, 82.1 ± 17.5 ml/min/1.73 m2; serum uric acid level, male, 5.8 ± 1.2 mg/dl, female, 4.1 ± 0.9 mg/dl. Both low and high serum uric acid levels were associated with the outcome and eGFR decline in males (multivariate logistic additional additive models, linear p = 0.0001, spline p = 0.043; generalized additive models, linear p = 0.0001, spline p = 0.012). In subjects with low serum uric acid levels (male, <5 mg/dl; female, <3.6 mg/dl), multivariate linear mixed models showed that low serum uric acid levels were associated with eGFR decline in a time-dependent manner (male, p = 0.0001; female, p = 0.045).

Conclusion: This study showed that low as well as high levels of uric acid are associated with the loss of kidney function. Hypouricemia is a candidate predictor of kidney function decline in healthy people.

Show MeSH
Related in: MedlinePlus