Relationship of Uric Acid With Progression of Kidney Disease

Chonchol, Michel; Shlipak, Michael G.; Katz, Ronit; Sarnak, Mark J.; Newman, Anne B.; Siscovick, David S.; Kestenbaum, Bryan; Carney, Jan; Fried, Linda F.

doi:10.1053/j.ajkd.2007.05.013

Cited by 365 publications

(305 citation statements)

References 33 publications

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“…Chonchol et al 5 evaluated the association between hyperuricemia and progression of kidney disease in the CHS, demonstrating a 14% (OR 1.14; 95% CI 1.04 to 1.24 per 1-mg/dl rise in uric acid) increase in kidney disease progression, defined by eGFR decline Ն3 ml/min per 1.73 m 2 /yr, but no relationship between baseline serum uric acid levels and incident CKD (OR 1.00; 95% CI 0.89 to 1.14). The results in our study differ, perhaps reflecting the limitations of serum creatininebased GFR estimates in the elderly, particularly at high eGFR levels.…”

Section: Discussionmentioning

confidence: 99%

“…17 In the case of allopurinol, it is likely that if uric acid is directly toxic to the kidney, then use of allopurinol would not significantly affect the results, whereas, if uric acid is a marker of kidney risk, then lack of allopurinol data would likely bias the results to the null. Notably, Chonchol et al 5 used medication data not available in the limited access CHS data set and found no significant difference in baseline allopurinol use across uric acid quintiles.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Ishani et al, 4 evaluating long-term follow-up of the Multiple Risk Factor Intervention Trial (MRFIT), found that higher uric acid levels were associated with the development of ESRD in men but that this result was attenuated when individuals with baseline CKD (estimated GFR [eGFR] Ͻ60 ml/min per 1.73 m 2 or proteinuria) were excluded. This suggests that uric acid may be a marker of diminished kidney func-tion rather than a cause of incipient kidney disease.…”

mentioning

confidence: 99%

“…This suggests that uric acid may be a marker of diminished kidney func-tion rather than a cause of incipient kidney disease. 4 Chonchol et al 5 evaluated the Cardiovascular Health Study (CHS) population of individuals who were Ն65 yr of age and found that there was a strong cross-sectional association between baseline uric acid levels and baseline kidney function. In longitudinal analyses, individuals with uric acid levels Ͼ5.9 mg/dl had increased risk for eGFR decline Ն3 ml/min per 1.73 m 2 annually; however, there was no significant association between uric acid level and incident CKD defined by eGFR Ͻ60 ml/min per 1.73 m 2 at the final study examination.…”

mentioning

confidence: 99%

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Uric Acid and Incident Kidney Disease in the Community

Weiner¹,

Tighiouart

Elsayed³

et al. 2008

Journal of the American Society of Nephrology

400

299

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Uric acid may mediate aspects of the relationship between hypertension and kidney disease via renal vasoconstriction and systemic hypertension. To investigate the relationship between uric acid and subsequent reduced kidney function, limited-access data of 13,338 participants with intact kidney function in two community-based cohorts, the Atherosclerosis Risks in Communities and the Cardiovascular Health Study, were pooled. Mean baseline serum uric acid was 5.9 Ϯ 1.5 mg/dl, mean baseline serum creatinine was 0.9 Ϯ 0.2 mg/dl, and mean baseline estimated GFR was 90.4 Ϯ 19.4 ml/min/1.73 m 2 . During 8.5 Ϯ 0.9 yr of follow-up, 712 (5.6%) had incident kidney disease defined by GFR decrease (Ն15 ml/min/1.73 m 2 with final GFR Ͻ60 ml/min/1.73 m 2 ), while 302 (2.3%) individuals had incident kidney disease defined by creatinine increase (Ն0.4 mg/dl with final serum creatinine Ͼ1.4 mg/dl in men and 1.2 mg/dl in women). In GFR-and creatinine-based logistic regression models, baseline uric acid level was associated with increased risk for incident kidney disease (odds ratio 1.07 [95% confidence interval 1.01 to 1.14] and 1.11 [95% confidence interval 1.02 to 1.21] per 1-mg/dl increase in uric acid, respectively), after adjustment for age, gender, race, diabetes, systolic BP, hypertension, cardiovascular disease, left ventricular hypertrophy, smoking, alcohol use, education, lipids, albumin, hematocrit, baseline kidney function and cohort; therefore, elevated serum uric acid level is a modest, independent risk factor for incident kidney disease in the general population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Uric Acid and Incident Kidney Disease in the Community

Weiner¹,

Tighiouart

Elsayed³

et al. 2008

Journal of the American Society of Nephrology

400

299

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“…In another study of 13,338 adults from the Atherosclerosis Risks in Communities and the Cardiovascular Health Study, a change in 1 mg/dl uric acid was independently associated with a 7 to 11% increased risk for developing CKD. 14 Alternatively, a study by Chonchol et al 15 could not confirm this association.…”

mentioning

confidence: 97%

Uric Acid Levels Increase Risk for New-Onset Kidney Disease

Mohandas

Johnson

2008

Journal of the American Society of Nephrology

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Association of Uric Acid–Lowering Therapy With Incident Chronic Kidney Disease

et al. 2022

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Key Points Question What is the association of uric acid–lowering therapy with the development of new onset chronic kidney disease (CKD)? Findings In this cohort study of 269 651 patients with estimated glomerular filtration rate of at least 60 mL/min/1.73 m 2 and no albuminuria, there was no beneficial association between initiating uric acid–lowering therapy and the incidence of CKD. Uric acid lowering–therapy was associated with a significantly higher risk of new-onset CKD. Meaning These findings do not support the initiation of uric acid–lowering therapy as a means to prevent the development of CKD.

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Relationship of Uric Acid With Progression of Kidney Disease

Cited by 365 publications

References 33 publications

Uric Acid and Incident Kidney Disease in the Community

Uric Acid and Incident Kidney Disease in the Community

Uric Acid Levels Increase Risk for New-Onset Kidney Disease

Association of Uric Acid–Lowering Therapy With Incident Chronic Kidney Disease

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