Significance of hyperuricemia as a risk factor for developing ESRD in a screened cohort

Iseki, Kunitoshi; Ikemiya, Yoshiharu; Inoue, Taku; Iseki, Chiho; Kinjo, Kozen; Takishita, Shuichi

doi:10.1016/s0272-6386(04)00934-5

Cited by 358 publications

(219 citation statements)

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“…However, recent studies suggest a possible role for uric acid as a mediator of kidney disease [13]. Indeed, hyperuricemia (but not uric acid level) was identified as an independent predictor of end-stage kidney disease in Japanese women [21]. However, the impact of increasing levels of uric acid on the development of kidney disease has not been intensively studied and whether there is a threshold uric acid level that enables progression to CKD remains unknown.…”

Section: Discussionmentioning

confidence: 99%

Uric Acid Levels Predict Future Development of Chronic Kidney Disease

et al. 2011

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Aims: Increased uric acid levels are associated with kidney dysfunction. We tested the hypothesis that uric acid level predicts future development of chronic kidney disease (CKD) in the general population. Methods: For this study, we enrolled 7,078 consecutive subjects with normal estimated glomerular filtration rates (eGFR; ≧60 ml/min/1.73 m²) who visited our hospital for a yearly health checkup (age: 52.8 ± 10.7 years; female: 35.8%). Subjects underwent a routine physical examination and laboratory assessment of cardiovascular disease risk factors at enrollment, and were followed up for 1,694 days (median) with the endpoint being the development of CKD (eGFR <60 ml/min/1.73 m²). The impact of uric acid and other cardiovascular risk factors at baseline on the future development of CKD were assessed. Results: During the follow-up period, 417 male (9.2%) and 151 female subjects (6.0%) developed CKD. Univariate logistic regression analysis revealed a significant association between the onset of CKD and age, male gender, body mass index, blood pressure, fasting plasma glucose, dyslipidemia and uric acid. Multiple logistic regression analysis revealed that new-onset CKD was independently correlated with the baseline uric acid level after adjustment for possible factors. Subanalysis showed similar results in subjects with normal uric acid levels (male: ≤7.0 mg/dl; female: ≤6.0 mg/dl; n = 6,223). Conclusion: Uric acid is an independent predictor of future development of CKD. Whether preventing an increase in uric acid levels reduces the incidence of CKD must be clarified by prospective follow-up studies.

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Section: Discussionmentioning

confidence: 99%

Uric Acid Levels Predict Future Development of Chronic Kidney Disease

et al. 2011

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“…Elevated SUA has been reported to be an independent risk factor for the development of chronic kidney disease [6,12,13,14]. To our knowledge, no study has addressed whether elevated uric acid is an independent risk factor for AKI.…”

Section: Discussionmentioning

confidence: 99%

Uric Acid: A Novel Risk Factor for Acute Kidney Injury in High-Risk Cardiac Surgery Patients?

et al. 2009

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Background: Uric acid has been reported to be a risk factor for the development of chronic kidney disease; however, no study has examined whether uric acid may confer a risk for acute kidney injury. Methods: We investigated the relation between serum uric acid and the incidence of postoperative acute kidney injury in patients undergoing high-risk cardiovascular surgery (cardiac valve and aneurysm surgery). Results: Following cardiovascular surgery, 18 of 58 patients (31%) developed acute kidney injury, with 11 of 24 (45.8%) in the elevated uric acid group (defined as >6 mg/dl) and 7 of 34 (20.5%) in the normal uric acid group (p = 0.05). After controlling for baseline renal function, left ventricular ejection fraction, use of nesiritide, type of surgery, and history of previous surgery, an elevated preoperative uric acid conferred a 4-fold risk for acute kidney injury (OR: 3.98, CI: 1.10–14.33, p = 0.035) and longer hospital stay (36.35 vs. 24.66 days, p = 0.009). Conclusion: This preliminary study suggests that uric acid may be a novel risk factor for acute kidney injury in patients undergoing high-risk cardiovascular surgery.

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“…A number of previous studies have reported a relation between serum uric acid levels and variable cardiovascular complication, including hypertension [3], metabolic syndrome [4], chronic kidney disease (CKD) [5], as well as with risk of coronary artery disease [6], cerebrovascular disease [7], and all-cause mortality [8]. However, whether hyperuricemia is an independent risk factor for cardiovascular disease (CVD) and mortality remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Hyperuricemia Is an Independent Risk Factor for Mortality Only if Chronic Kidney Disease Is Present

Chung¹,

Kim²,

Ro³

et al. 2013

Am J Nephrol

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Background/Aims: Hyperuricemia has been considered a risk factor for renal disease and cardiovascular disease. However, the potential contribution of hyperuricemia to mortality remains uncertain, and the results in the available literature vary according to kidney function. The aim of this study was to determine the association between hyperuricemia and mortality in patients undergoing percutaneous coronary intervention (PCI) across the interaction of kidney function. Method: We retrospectively reviewed patients who underwent PCI from 2003 to 2009. Propensity scores for hyperuricemia (>7 mg/dl for males and >6 mg/dl for females) were used to assemble a matched cohort of 693 pairs of patients with and without hyperuricemia for analysis from the 3,201 patients who fulfilled the inclusion criteria among the 4,842 patients who underwent PCI. Results: Of the 3,201 patients who underwent PCI and for whom data were available regarding their baseline serum uric acid level, 763 (23.8%) had hyperuricemia. The hyperuricemia-associated hazard ratios (HRs) [95% confidence intervals (CIs)] for all-cause mortality were 1.780 (1.270-2.495) in the unmatched cohort and 1.655 (1.109-2.468) in the matched cohort. The HRs (95% CI) for all-cause mortality among those with and without chronic kidney disease (CKD) were 2.080 (1.318-3.283) and 1.592 (0.778-3.256), respectively (p for interaction, 0.001). Conclusions: Hyperuricemia is an independent risk factor for all-cause mortality in those patients with CKD but not in those without CKD.

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Significance of hyperuricemia as a risk factor for developing ESRD in a screened cohort

Cited by 358 publications

References 0 publications

Uric Acid Levels Predict Future Development of Chronic Kidney Disease

Uric Acid Levels Predict Future Development of Chronic Kidney Disease

Uric Acid: A Novel Risk Factor for Acute Kidney Injury in High-Risk Cardiac Surgery Patients?

Hyperuricemia Is an Independent Risk Factor for Mortality Only if Chronic Kidney Disease Is Present

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