Elevated Serum Uric Acid is Associated with Rapid Decline in Kidney Function: A 10-Year Follow-Up Study
Authors Kritmetapak K, Charoensri S, Thaopanya R, Pongchaiyakul C
Received 20 August 2020
Accepted for publication 7 October 2020
Published 23 October 2020 Volume 2020:13 Pages 945—953
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Kittrawee Kritmetapak,1 Suranut Charoensri,2 Rattrai Thaopanya,3 Chatlert Pongchaiyakul2
1Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 2Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 3Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Correspondence: Chatlert Pongchaiyakul
Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
Purpose: The long-term impact of changes in serum uric acid (SUA) concentration on the estimated glomerular filtration rate (eGFR) among the general population remains unclear. We investigated the longitudinal associations between changes in SUA and eGFR over 10 years in 1222 participants with baseline eGFR ≥ 60 mL/min/1.73 m2.
Methods: This was a 10-year retrospective cohort study conducted from 2007 to 2017. Rapid eGFR decline (defined as the highest quartile of change in eGFR between 2007 and 2017) and new-onset kidney disease (defined as an eGFR < 60 mL/min/1.73 m2 at a 10-year follow-up) were examined using multiple logistic regression analysis, adjusted for sex, age, body mass index, systolic blood pressure, SUA, fasting plasma glucose, serum total cholesterol, and triglyceride at baseline.
Results: SUA was inversely correlated with eGFR, and the slopes of the SUA-eGFR regression lines were consistently steeper in females than males. A significant inverse correlation was also observed between 10-year changes in SUA and eGFR in both sexes. Multivariate analysis showed that every 1 mg/dL increase in SUA from baseline was associated with higher risk of rapid eGFR decline and new-onset kidney disease (OR 1.25; 95% CI 1.14– 1.33 and OR 1.40; 95% CI 1.26– 1.49, respectively). Furthermore, the subjects in the highest SUA quartile (> 6.0 mg/dL) had a 2.45 times higher risk of rapid eGFR decline (95% CI 1.51– 3.42) compared to those in the lowest SUA quartile (< 3.9 mg/dL).
Conclusion: Elevated baseline SUA is an independent risk factor for rapid eGFR decline and new-onset kidney disease in the general population.
Keywords: chronic kidney disease, epidemiology, glomerular filtration rate, risk factors, uric acid
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