The prevalence, subtypes and associated factors of hyperuricemia in lupus nephritis patients at chronic kidney disease stages 1-3

Abstract

There is a high prevalence of hyperuricemia (HUA) in the chronic kidney disease (CKD) population. However, there’s a dearth of research on HUA’s prevalence, subtypes, early detection, and treatment strategies of HUA in lupus nephritis (LN) patients. The aim of this study is to address these knowledge gaps. LN patients presenting to the Department of Nephrology at Shanghai Rui Jin Hospital from January 2011 to January 2016 were recruited. The effective sample size was derived using the power analysis. The demographic, clinical and laboratory characteristics of the LN patients with HUA were compared with those of patients without HUA. Two statistical models for analyzing HUA were built and compared using the receiver operating characteristic (ROC) curve analysis. The total prevalence of HUA in the cohort was 40.11%. The subtypes of HUA included urate underexcretion-type, overproduction-type and combined-type, which proportion being 67.7%, 9.7% and 22.6% respectively. The CKD stage was closely associated with the prevalence of HUA in patients with LN. The other significant associated factors were hypertension, triglycerides, serum creatinine, serum albumin, hemoglobin, parathyroid hormone, phosphorus, calcium, etc. The statistical algorithm successfully identified LN patients at risk of HUA. In conclusion, there was a high prevalence of HUA in LN patients at CKD stages 1–3, and renal underexcretion hyperuricemia was the most prevalent subtype. The occurrence of HUA in LN may be related to renal insufficiency, metabolic disorder and lupus itself. Early care coordination programs can employ risk models to improve HUA prevention and target interventions in LN patients.

The physiology of uric acid and the impact of end‐stage kidney disease and dialysis

“…Although intestinal up‐regulation of UA secretion in patients with kidney disease may occur, this compensatory mechanism is likely insufficient, as the prevalence of elevated serum UA levels increases with kidney disease progression, being present in over 90% of individuals with advanced CKD . The possibility of uremic toxin interference with intestinal UA transporters as an explanation for ineffectual intestinal UA excretion has been briefly explored .…”

Serum Uric Acid is Associated with Renal Prognosis of Lupus Nephritis in Women but not in Men

“…In LN patients with CKD stages prevalence of hyperuricemia in SLE patients is reported to be approximately 16.1% [12] and 29% [13]. In LN patients with CKD stages 1-3, the prevalence of HUA was 40.1% [14]. Despite the fact that hyperuricemia often occurs in SLE patients, the association between LN and hyperuricemia remains insufficiently studied.…”

Polymorphism of ABCG2 Gene in Hyperuricemia Patients of Han And Uygur Ethnicity with Phlegm/Non-Phlegm Block in Xinjiang, China

“…Hyperuricemia is a group of diseases caused by excess uric acid and/or decreased uric acid excretion by the kidneys, and it is a type of metabolic syndrome [ 1 ]. Hyperuricemia is diagnosed if the blood uric acid is higher than 420 μmol/l (7 mg/dl) in males and higher than 357 μmol/l (6 mg/dl) in premenopausal women [ 2 , 3 ]. Many studies have shown that hyperuricemia is the pathological basis of gouty arthritis, kidney stones, renal failure, and metabolic syndromes such as hypertension, atherosclerosis, coronary heart disease, glycolipid metabolic disorders, obesity, and insulin resistance disease [ 4 , 5 ].…”