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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 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.The outcome event was incident CKD or the decrease in eGFR by more than 25% in three years.

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

Exercise load and risk of loss of kidney function in subjects with low serum uric acid levels.The risk of loss of kidney function was increased by a high exercise load in males. Exercise load: Male; level 1, almost no exercise; level 2, once a moth; level 3, twice a month; level 4, once a week or more. Female; level 1, almost no exercise; level 2, once a moth; level 3, twice a month or more. Abbreviations: Incidence, incidence of loss of kidney function; Male, serum uric acid levels were less than 5 mg/dl; Female, serum uric acid levels were less than 3.6 mg/dl.
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pone.0118031.g004: Exercise load and risk of loss of kidney function in subjects with low serum uric acid levels.The risk of loss of kidney function was increased by a high exercise load in males. Exercise load: Male; level 1, almost no exercise; level 2, once a moth; level 3, twice a month; level 4, once a week or more. Female; level 1, almost no exercise; level 2, once a moth; level 3, twice a month or more. Abbreviations: Incidence, incidence of loss of kidney function; Male, serum uric acid levels were less than 5 mg/dl; Female, serum uric acid levels were less than 3.6 mg/dl.

Mentions: The effect of exercise on the loss of kidney function was examined in subjects with low serum uric acid levels. Regular exercise was negatively associated with the loss of kidney function in males (Table 3). A high exercise load tended to be associated with the outcome events in males (Chi-square test, p = 0.027), but not in females (p = 0.94) (Fig. 4).


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)

Exercise load and risk of loss of kidney function in subjects with low serum uric acid levels.The risk of loss of kidney function was increased by a high exercise load in males. Exercise load: Male; level 1, almost no exercise; level 2, once a moth; level 3, twice a month; level 4, once a week or more. Female; level 1, almost no exercise; level 2, once a moth; level 3, twice a month or more. Abbreviations: Incidence, incidence of loss of kidney function; Male, serum uric acid levels were less than 5 mg/dl; Female, serum uric acid levels were less than 3.6 mg/dl.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0118031.g004: Exercise load and risk of loss of kidney function in subjects with low serum uric acid levels.The risk of loss of kidney function was increased by a high exercise load in males. Exercise load: Male; level 1, almost no exercise; level 2, once a moth; level 3, twice a month; level 4, once a week or more. Female; level 1, almost no exercise; level 2, once a moth; level 3, twice a month or more. Abbreviations: Incidence, incidence of loss of kidney function; Male, serum uric acid levels were less than 5 mg/dl; Female, serum uric acid levels were less than 3.6 mg/dl.
Mentions: The effect of exercise on the loss of kidney function was examined in subjects with low serum uric acid levels. Regular exercise was negatively associated with the loss of kidney function in males (Table 3). A high exercise load tended to be associated with the outcome events in males (Chi-square test, p = 0.027), but not in females (p = 0.94) (Fig. 4).

Bottom Line: 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.The outcome event was incident CKD or the decrease in eGFR by more than 25% in three years.

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