Uric acid as a risk factor for progression of non-diabetic chronic kidney disease? The Mild to Moderate Kidney Disease (MMKD) Study

Sturm, Gisela; Kollerits, Barbara; Neyer, Ulrich; Ritz, Eberhard; Kronenberg, Florian

doi:10.1016/j.exger.2008.01.006

Cited by 152 publications

(116 citation statements)

References 52 publications

Supporting

Mentioning

111

Contrasting

Unclassified

Order By: Relevance

“…This habit is not unique to Italian nephrologists or specific to our cohort. Indeed, in a cohort enrolling patients with CKD in central Europe (the Mildto-Moderate Kidney Disease study), the proportion of patients treated with allopurinol was 30% (6). Such a high proportion is also common in other observation studies in European cohorts.…”

Section: Discussionmentioning

confidence: 96%

“…Some cohort studies reported a relationship between uric acid plasma levels and the risk of CKD progression (2-5) but such an association was negated in other follow-up studies (6,7). Small clinical trials (8)(9)(10) and experimental studies in animal models (11)(12)(13) suggest a benefit of uric acid-lowering interventions on renal disease progression.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association of a Polymorphism in a Gene Encoding a Urate Transporter with CKD Progression

Testa

Mallamaci

Spoto

et al. 2014

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and objectives Hyperuricemia predicts a high risk for CKD progression but there is no large clinical trial in humans indicating that this relationship is causal in nature. The rs734553 single-nucleotide polymorphism (SNP) of the GLUT9 urate transporter gene was strongly associated with uric acid (UA) levels in a large metaanalysis.Design, setting, participants, & measurements This prospective study adopted the Mendelian randomization approach. The rs734553 SNP was used as an instrumental variable to investigate the relationship between UA and renal outcomes in a cohort of 755 patients with CKD who were enrolled between October 18, 2005, and October 2, 2008. The association between the polymorphism and UA was preliminary confirmed in a series of 211 healthy volunteers enrolled between January 1, 2001, and July 12, 2011, from the same geographic area as the patients with CKD. The study end point was a composite renal-end point (i.e., .30% decrease in the GFR, dialysis, or transplantation). Patients were followed up for a median of 36 months.Results In healthy individuals, serum UA levels were highest in homozygotes for the T allele (risk allele), intermediate in heterozygotes for the same allele, and lowest in those without the risk allele (P,0.001), but no such relationship was found in patients with CKD. In the CKD cohort, homozygotes (TT) and heterozygotes (GT) for the risk allele had a 2.35 times higher risk (hazard ratio, 2.35; 95% confidence interval, 1.25 to 4.42; P=0.008) of CKD progression. The risk for CKD progression by rs734553 remained unmodified in analyses adjusting for proteinuria, GFR, and other classical and CKD-peculiar risk factors.Conclusions A GLUT9 polymorphism, which is strongly associated with serum UA levels in healthy individuals of the general population with normal renal function, holds a strong predictive power for CKD progression. These findings are compatible with the hypothesis that the link between UA and CKD progression is causal in nature.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Association of a Polymorphism in a Gene Encoding a Urate Transporter with CKD Progression

Testa

Mallamaci

Spoto

et al. 2014

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…Conversely, other reports have not supported the hypothesis that sUA contributes to chronic kidney disease 21,22,23,24 , including a cohort study of 5808 elderly participants in which sUA showed a significant association with prevalent but not incident kidney disease 21 .…”

Section: Rheumatologymentioning

confidence: 77%

Serum Urate and Incidence of Kidney Disease Among Veterans with Gout

Krishnan

Akhras²,

Sharma³

et al. 2013

J Rheumatol

View full text Add to dashboard Cite

Objective.To study the association between serum urate level (sUA) and the risk of incident kidney disease among US veterans with gouty arthritis.Methods.From 2002 through 2011 adult male patients with gout who were free of kidney disease were identified in the data from the Veterans Administration VISN 16 database and were followed until incidence of kidney disease, death, or the last available observation. Accumulated hazard curves for time to kidney disease were estimated for patients with average sUA levels > 7 mg/dl (high) versus ≤ 7 mg/dl (low) based on Kaplan-Meier analyses; and statistical comparison was conducted using a log-rank test. A Cox proportional hazard model with time-varying covariates was used to estimate the unadjusted and adjusted hazard ratios for kidney disease.Results.Eligible patients (n = 2116) were mostly white (53%), with average age 62.6 years, mean body mass index 31.2 kg/m2, and high baseline prevalence of hypertension (93%), hyperlipidemia (67%), and diabetes (20%). Mean followup time was 6.5 years. The estimated rates of all incident kidney disease in the overall low versus high sUA groups were 2% versus 4% at Year 1, 3% versus 6% at Year 2, and 5% versus 9% at Year 3, respectively (p < 0.0001). After adjustment, high sUA continued to predict a significantly higher risk of kidney disease development (HR 1.43, 95% CI 1.20–1.70).Conclusion.Male veterans with gout and sUA levels > 7 mg/dl had an increased incidence of kidney disease.

show abstract

“…In addition, we also reported that decreasing serum uric acid levels in men was associated with improving eGFR with lifestyle modification with a 1-year follow up [5]. In turn, there are some reports correlated to the association between serum uric acid levels and CKD in foreign countries [6][7][8][9][10][11]. However, whether decreases in serum uric acid levels with lifestyle modification are beneficial for improving eGFR, and what affects this has on eGFR remains to be evaluated in a longitudinal study in Japanese women.…”

Section: Introductionmentioning

confidence: 88%

“…Higher serum uric acid levels are closely linked to the development of renal injury and end-stage renal disease [6][7][8][9][10][11]. Yen et al proved that serum uric acid levels were associated with eGFR and declined in renal function in elderly Taiwanese subjects in a longitudinal analysis [6].…”

Section: Discussionmentioning

confidence: 99%

Decreasing serum uric acid levels are associated with improving estimated glomerular filtration rate (eGFR) in Japanese women

Miyatake¹,

Shikata²,

Makino³

et al. 2013

OJEpi

View full text Add to dashboard Cite

The aim of this study was to investigate the link between changes in a subject's serum uric acid levels and the estimated glomerular filtration rate (eGFR) in Japanese women. We used data for 161 Japanese women (49.8 ± 11.7 years) with a 1-year follow up. eGFR was defined by a new equation developed for Japan. eGFR was negatively correlated with serum uric acid levels (r = −0.402, p < 0.0001) at baseline. Subjects were given advice for dietary and lifestyle improvement. At the 1-year follow up, abdominal circumference and systolic blood pressure (SBP) were significantly improved. However, uric acid and eGFR did not change. The changes in eGFR were negatively correlated with uric acid (r = −0.475, p < 0.0001). A decrease in serum uric acid levels was associated with improving eGFR in Japanese women.

show abstract

Uric acid as a risk factor for progression of non-diabetic chronic kidney disease? The Mild to Moderate Kidney Disease (MMKD) Study

Cited by 152 publications

References 52 publications

Association of a Polymorphism in a Gene Encoding a Urate Transporter with CKD Progression

Association of a Polymorphism in a Gene Encoding a Urate Transporter with CKD Progression

Serum Urate and Incidence of Kidney Disease Among Veterans with Gout

Decreasing serum uric acid levels are associated with improving estimated glomerular filtration rate (eGFR) in Japanese women

Contact Info

Product

Resources

About