Hyperuricemia is a risk factor for the progression to end-stage renal disease in minimal change disease

Abstract

Background Minimal change disease (MCD) is one of the most common causes of nephrotic syndrome worldwide. Hyperuricemia increases the end-stage renal disease (ESRD) risk in glomerulonephritis. In this study, we aimed to determine the effect of high serum uric acid levels on the progression to ESRD in MCD. Methods A total of 800 patients diagnosed with MCD by kidney biopsy were retrospectively analyzed. We determined the relationship of hyperuricemia with the progression to ESRD in MCD using the Cox proportional hazard model and Kaplan-Meier survival analysis. The primary outcome was defined as the initiation of dialysis or kidney transplantation. Results A total of 42 patients (5.3%) progressed to ESRD during the follow-up period. In the restricted cubic spline curve, serum uric acid levels exhibited a positive correlation with ESRD progression in patients with MCD. In the fully adjusted model, the risk of MCD progression increased by 29% for every 1 mg/dL increase in the baseline serum uric acid level (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.09–1.54; p = 0.004). Falling into the high uric acid group (serum uric acid level > 7 mg/dL in men and > 6 mg/dL in women) was also a risk factor for progression of MCD to ESRD (HR, 3.40; 95% CI, 1.59–7.31; p < 0.001). Conclusion Our study shows that hyperuricemia is an independent risk factor for the progression to ESRD in patients with MCD.

Mendelian randomization reveals causal effects of kidney function on various biochemical parameters

“…Blood urea is a secondary kidney function parameter, and serum albumin might have been affected by impaired volume homeostasis or urine albumin loss related to kidney function impairment. Urate is a well-known parameter that is closely associated with eGFR values 3 , 11 , particularly in CKD patients, and our results showed that eGFR decline would causally increase serum urate levels.…”

In Vitro Diagnostic Examination and Prognosis Surveillance by Hierarchical Heterojunction-Assisted Metabolic Analysis

“…43 A recent research shows that the risk of MCD progression increases by 29% for every 1 mg dL −1 increase of the uric acid level in the baseline. 44 Valine is one of the three branched-chain amino acids that is essential for animal health and important in metabolism, 45 the urinary level of which is found to decrease in PNS, 46 which is consistent with our results (Figure 5). Notably, it is inevitable that all these nine metabolites participate in various renal activities.…”

“…As known, arginine is directly related to the production of nitric oxide in the body and participates in the regulation of end-stage renal degeneration. , More specifically, uric acid as the end product of purine metabolism has been normally known to impact the kidneys through causing nephrolithiasis and acute kidney injury . A recent research shows that the risk of MCD progression increases by 29% for every 1 mg dL –1 increase of the uric acid level in the baseline . Valine is one of the three branched-chain amino acids that is essential for animal health and important in metabolism, the urinary level of which is found to decrease in PNS, which is consistent with our results (Figure ).…”

Predictive Parameters of Steroid Dependency in Minimal Change Disease

“…This study showed that uric acid levels were associated with steroid dependency in MCD. Song et al 26 revealed hyperuricemia as an independent risk factor for progression to end stage kidney disease in children with MCD. Asakawa et al 27 reported that hyperuricemia was related to podocyte injury and proteinuria.…”