Association between serum uric acid and new onset and progression of chronic kidney disease in a Japanese general population: Iki epidemiological study of atherosclerosis and chronic kidney disease

Tada, Kazuhiro; Maeda, Toshiki; Takahashi, Koji; Ito, Kenji; Yasuno, Tetsuhiko; Satoh, Atsushi; Kawazoe, Miki; Yoshimura, Chikara; Mukoubara, Shigeaki; Masutani, Kosuke; Arima, Hisatomi; Nakashima, Hitoshi

doi:10.1007/s10157-021-02042-7

Cited by 12 publications

(11 citation statements)

References 26 publications

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“…This study was a population‐based retrospective cohort study of the residents of Iki City, Nagasaki Prefecture, Japan, and used data from the Iki Epidemiological Study of Atherosclerosis and Chronic Kidney Disease (ISSA‐CKD) study, which has been described in detail previously. 10 , 11 , 12 , 13 , 14 , 15 Iki City is located in the north of Nagasaki Prefecture and has a population of approximately 27 000. We enrolled 7895 participants aged ≥30 years who underwent annual health check‐ups conducted by the local government of Iki City between 2008 and 2017.…”

Section: Methodsmentioning

confidence: 99%

Effect of chronic kidney disease on the association between hyperuricemia and new‐onset hypertension in the general Japanese population: ISSA‐CKD study

Kawazoe

Ishida

Yoshimura

et al. 2021

J of Clinical Hypertension

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We aimed to investigate the association between serum uric acid (SUA) level and development of hypertension as well as the interaction effect of chronic kidney disease (CKD) on this relationship in the general Japanese population. We included 7895 participants aged ≥30 years from the ISSA‐CKD study, a population‐based retrospective cohort study that used annual health check‐up data of residents from Iki Island, Japan. After the exclusion of 1881 with l < 1‐year follow‐up, 2812 with hypertension at baseline, and 165 with missing information on SUA, a total of 3037 participants were enrolled in this analysis. Participants were divided into four groups according to the quartiles of SUA level at baseline, and multivariable‐adjusted hazard ratios for new‐onset hypertension were calculated. Stratified analyses were performed for each subgroup (defined by sex, age, alcohol intake, and CKD) to assess the interaction effects. During a mean follow‐up period of 4.4 years, 943 participants developed hypertension. The first quartile group was set as the reference group, and the multivariable‐adjusted hazard ratios (95% confidence interval) for new‐onset hypertension were 1.11 (0.90–1.36) in the second quartile, 1.25 (1.02–1.54) in the third quartile, and 1.35 (1.07–1.70) in the fourth quartile compared with those in the reference group ( p = .007 for trend). The stratified analyses showed that the association between SUA and hypertension was significantly stronger in participants with CKD than in those without CKD ( p = .035 for interaction). SUA level is an independent risk factor for new‐onset hypertension. This tendency was significantly stronger in participants with CKD.

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Section: Methodsmentioning

confidence: 99%

Effect of chronic kidney disease on the association between hyperuricemia and new‐onset hypertension in the general Japanese population: ISSA‐CKD study

Kawazoe

Ishida

Yoshimura

et al. 2021

J of Clinical Hypertension

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“…In a study by Chang YH et al, uric acid played a pathogenic role only when the value exceeded 6.3 mg/dl, and a lower uric acid level might be beneficial to the improvement of renal function in participants with diabetic nephropathy [ 27 ]. Based on a Japanese general population containing 5507 participants, Tada K et al reported that there was no statistically significant correlation between SUA levels and the progression of CKD [ 28 ]. Srivastava A et al compared the relationship in different CKD stages and found a potentially protective effect between higher UA levels and renal dysfunction in participants with CKD stage 4 or 5 [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

The Association between Baseline, Changes in Uric Acid, and Renal Failure in the Elderly Chinese Individuals: A Prospective Study with a 3-Year Follow-Up

Lai

Zhou

et al. 2022

International Journal of Endocrinology

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Objective. The objective is to find whether serum uric acid (SUA) levels are associated with the progression of chronic kidney disease (CKD) remains uncertain, and follow-up data among the elderly population are relatively lacking, especially in China. The aim of the present study was to reveal the association between baseline SUA levels, changes in SUA levels, and renal failure in Chinese elderly adults. Methods. In this retrospective cohort study, 425 subjects (age range 71–100 years) were analyzed and divided into quartiles based on baseline SUA levels (Q1: <4.8; Q2: <5.7; Q3: <6.5; and Q4: ≥6.5 mg/dl). CKD was defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2. We used multiple linear and logistic regressions to compare the risk of renal dysfunction among the different SUA level groups. Results. The prevalence of hyperuricemia was 24.24% in the elderly subjects. In the multivariable analysis, the odds ratio (OR) for the development of CKD increased with the increase in SUA quartiles at baseline (1.00 vs. 1.79 (95% CI, 1.00–3.22), 3.4 (95% CI, 1.79–6.47), and 6.79 (95% CI, 3.45–13.75), respectively; P for linear trend <0.001), and a per unit increase in baseline SUA levels gave an OR of 1.76 (95% CI, 1.45–2.14) for renal failure. At the same time, a change in SUA levels had a stronger inverse correlation with a change in eGFR in females (r = −0.318, P < 0.001 ) than in males (r = −0.187, P < 0.01 ). In a linear regression analysis, a 1 mg/dl increase in SUA levels was associated with an additional 1.25 (95% CI, −1.83 to −0.67) ml/min/1.73 m2 decrease in eGFR over a 3-year period. Conclusion. Elevated baseline SUA levels and changes in SUA levels were associated with a decline in eGFR and an increased risk of CKD in an elderly Chinese population.

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“…In our population study, the UA level at 3 months after OLT was found to be a risk factor for new-onset CKD. Elevated serum levels of UA are associated with the onset and progression of CKD in many populations, such as the general population [ 22 ], patients with hypertension [ 23 ], and kidney transplantation patients [ 24 ]. Although hyperuricaemia is common after OLT, its association with the development of CKD has not been well described.…”

Section: Discussionmentioning

confidence: 99%

Prediction of chronic kidney disease after orthotopic liver transplantation: development and validation of a nomogram model

Guo

Wang

et al. 2022

BMC Nephrol

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Background We aimed to develop and validate a nomogram model for predicting CKD after orthotopic liver transplantation (OLT). Methods The retrospective data of 399 patients who underwent transplantation and were followed in our centre were collected. They were randomly assigned to the training set (n = 293) and validation set (n = 106). Multivariable Cox regression analysis was performed in the training set to identify predictors of CKD. According to the Cox regression analysis results, a nomogram model was developed and validated. The renal function of recipients was monitored, and the long-term survival prognosis was assessed. Results The incidence of CKD at 5 years after OLT was 25.6%. Cox regression analysis identified several predictors of post-OLT CKD, including recipient age at surgery (HR 1.036, 95% CI 1.006-1.068; p = 0.018), female sex (HR 2.867, 95% CI 1.709-4.810; p < 0.001), preoperative hypertension (HR 1.670, 95% CI 0.962-2.898; p = 0.068), preoperative eGFR (HR 0.996, 95% CI 0.991-1.001; p = 0.143), uric acid at 3 months (HR 1.002, 95% CI 1.001-1.004; p = 0.028), haemoglobin at 3 months (HR 0.970, 95% CI 0.956-0.983; p < 0.001), and average concentration of cyclosporine A at 3 months (HR 1.002, 95% CI 1.001-1.003; p < 0.001). According to these parameters, a nomogram model for predicting CKD after OLT was constructed and validated. The C-indices were 0.75 and 0.80 in the training and validation sets. The calibration curve of the nomogram showed that the CKD probabilities predicted by the nomogram agreed with the observed probabilities at 1, 3, and 5 years after OLT (p > 0.05). Renal function declined slowly year by year, and there were significant differences between patients divided by these predictors. Kaplan-Meier survival analysis showed that the survival prognosis of recipients decreased significantly with the progression of renal function. Conclusions With excellent predictive abilities, the nomogram may be a simple and reliable tool to identify patients at high risk for CKD and poor long-term prognosis after OLT.

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Association between serum uric acid and new onset and progression of chronic kidney disease in a Japanese general population: Iki epidemiological study of atherosclerosis and chronic kidney disease

Cited by 12 publications

References 26 publications

Effect of chronic kidney disease on the association between hyperuricemia and new‐onset hypertension in the general Japanese population: ISSA‐CKD study

Effect of chronic kidney disease on the association between hyperuricemia and new‐onset hypertension in the general Japanese population: ISSA‐CKD study

The Association between Baseline, Changes in Uric Acid, and Renal Failure in the Elderly Chinese Individuals: A Prospective Study with a 3-Year Follow-Up

Prediction of chronic kidney disease after orthotopic liver transplantation: development and validation of a nomogram model

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