Significance of Hyperuricemia on the Early Detection of Renal Failure in a Cohort of Screened Subjects.

Abstract

A high level of serum creatinine (S-Cr) is a predictor of end-stage renal disease (ESRD), but only a few studies have investigated the prevalence of high S-Cr and its correlates in a large population. We analyzed the data collected from 6,403 subjects (4,222 men and 2,181 women) who participated in the Okinawa General Health Maintenance Association (OGHMA) screening both at 1997 and 1999. The computer-saved data included sex, age, blood chemistries, blood pressure, medical histories, and lifestyles. Multivariate Cox proportional hazard analyses were performed to identify the correlates of developing high S-Cr levels: > or = 1.4 mg/dl in men and > or = 1.2 mg/dl in women. The prevalence of high S-Cr was 3.0% (N=193), which was 4.1% in men (N=175) and 0.8% in women (N=18), and increased with age in both sexes at the 1997 screening. Among those who showed normal levels of S-Cr in 1997 (N=6,210), 241 subjects (223 men and 18 women) developed high S-Cr. The 2-year cumulative incidence of high S-Cr was 5.5% in men and 0.8% in women. Other than sex, serum uric acid was the most significant correlate for developing high S-Cr. The adjusted relative risk (95% confidence interval) of those with serum uric acid 8.0 mg/dl and over was 2.91 (1.79-4.75) in men and 10.39 (1.91-56.62) in women when compared to those with serum uric acid less than 5.0 mg/dl. Prevalence of high levels of S-Cr was relatively high in men. Other than gender, serum uric acid was a significant positive correlate of developing high S-Cr in this sample of the Japanese population.

Prevalence and risk factors for renal artery stenosis and chronic kidney disease in Japanese patients with peripheral arterial disease

“…28 In a community-based study of Japanese adults, hyperuricemia and age emerged as significant risk factors for renal failure, and hyperuricemia was more strongly predictive than proteinuria. 29 Our study also highlights the correlation between CKD and the level of uric acid. As CKD seems to be a risk factor in PAD, 4 treatment for hyperuricemia is important in patients with PAD.…”

A Role for Uric Acid in the Progression of Renal Disease

“…This increased relative risk was independent of age, body mass index, systolic BP, total cholesterol, serum albumin, glucose, smoking, alcohol use, exercise habits, proteinuria, and hematuria (28). Indeed, an elevated uric acid was more predictive for the development of renal insufficiency than proteinuria (28). We therefore investigated the effects and the action mechanism of hyperuricemia on the progression of renal disease in the classic RK model in rats.…”

“…Furthermore, in a recent study of 6400 subjects with normal renal function, a serum uric acid of Ͼ8.0 mg/dl, when compared with a serum uric acid level of Ͻ5.0 mg/dl, was associated with a 2.9-fold increased risk for developing renal insufficiency within 2 yr in men and a 10.0-fold increased risk in women (28). This increased relative risk was independent of age, body mass index, systolic BP, total cholesterol, serum albumin, glucose, smoking, alcohol use, exercise habits, proteinuria, and hematuria (28). Indeed, an elevated uric acid was more predictive for the development of renal insufficiency than proteinuria (28).…”

The conundrum of hyperuricemia, metabolic syndrome, and renal disease

“…Furthermore, recent studies have shown that hyperuricemia was associated with a decline of renal function, hypertension, diffuse proliferative glomerulonephritis, and tubulointerstitial damage in IgA nephropathy [13], and serum uric acid positively correlates with urinary albumin excretion in type 2 diabetes in Taiwan [14]. In addition, in one study uric acid was found to be a better risk factor than proteinuria for development of renal insufficiency [12]. Thus, the role of uric acid in renal disease still remains to be addressed.…”

“…In contrast, a potential causal role of uric acid in renal disease was supported by evidence that uric acid was a risk factor for renal failure among over 49,000 male in the general Japanese population with a relative risk (RR) of 8.52 [11]. Similarly, hyperuricemia was reported to be a risk factor for renal insufficiency in 3,499 patients in Thailand and 6,300 subjects in Japan [12]. Furthermore, recent studies have shown that hyperuricemia was associated with a decline of renal function, hypertension, diffuse proliferative glomerulonephritis, and tubulointerstitial damage in IgA nephropathy [13], and serum uric acid positively correlates with urinary albumin excretion in type 2 diabetes in Taiwan [14].…”