Interactive association of baseline and changes in serum uric acid on renal dysfunction among community‐dwelling persons

Abstract

Background: Chronic kidney disease (CKD) is a major public health concern. Baseline serum uric acid (SUA) levels were independently associated with incident renal dysfunction, but whether baseline and changes in SUA produce an interactive effect on renal dysfunction remains unclear. Methods:The subjects comprised 460 men aged 68 ± 10 (mean ± standard deviation) years and 635 women aged 68 ± 9 years from a rural village. We have found participants who underwent a similar examination 3 years later, and analyzed the relationship between baseline SUA, changes in SUA, and a 3-year follow-up renal function evaluated by estimated glomerular filtration rate (eGFR). Results:A total of 93 (20.2%) men and 76 (12.0%) women had hyperuricemia (men: SUA ≥ 7.0 mg/dL and women: SUA ≥ 6.0 mg/dL) at baseline. Multiple regression analysis using changes in eGFR as objective variable, adjusted for risk factors as explanatory variables, showed that the baseline SUA and changes in SUA were linearly associated with changes in eGFR (β = -0.115, P < .001 and β = -0.431, P < .001, respectively). In both normal SUA group and hyperuricemia group, changes in SUA significantly associated with changes in eGFR (β = -0.473, P < .001 and β = -0.197, P = .009, respectively). Participants with increased SUA from normal to hyperuricemia group had greater eGFR decline over the follow-up period, and their multivariate-adjusted 3-year follow-up eGFR was significantly lower than in other groups (P < .001). Conclusion: Our data demonstrated that baseline and longitudinal changes in SUAwere independently and interactively associated with the renal function decline among community-dwelling persons. K E Y W O R D Scommunity-dwelling person, eGFR, retrospective cohort study, serum uric acid

A follow‐up study to explore factors associated with rapid kidney function decline and new‐onset kidney disease among Chinese elderly population

“…Moreover, elevated SUA change was reported to predict rapid eGFR decline (OR: 2.62; 95% CI: 2.22–3.12) significantly, and new‐onset kidney disease (OR: 2.16; 95% CI: 1.93–2.42) among Chinese elderly population. The finding was well aligned with the other two longitudinal research studies, which reported that elevated SUA change was an important risk factor for the renal function decline among the Japanese young population 19 and Japanese elderly community‐dwelling persons 10 . Our research also found that elderly people with elevated SUA change from the normal group to the hyperuricemia group witnessed the highest decrease of eGFR after the 5‐year follow‐up than participants in the other groups, which further confirmed the significant relationship between elevated SUA change and eGFR decline over 5 years ( r = −0.407, P < 0.001) in the research.…”

“…The finding was well aligned with the other two longitudinal research studies, which reported that elevated SUA change was an important risk factor for the renal function decline among the Japanese young population 19 and Japanese elderly community-dwelling persons. 10 Our research also found that elderly people with elevated SUA change from the normal group to the hyperuricemia group witnessed the highest decrease of eGFR after the 5-year follow-up than participants in the other groups, which further confirmed the significant relationship between elevated SUA change and eGFR decline over 5 years (r = À0.407, P < 0.001) in the research. We observed a stronger inverse correlation between SUA change and eGFR decline in women (r = À0.406, P < 0.001) than in men (r = À0.355, P < 0.001).…”

“…14 Moreover, most of the related studies used cross-sectional design, 13,[15][16][17] and only three studies were conducted to explore the influence of longitudinal SUA changes on the renal dysfunction in the general population of Japan and Thailand. 2,10,18 Therefore, our research contributed to exploring potential factors associated with rapid kidney function decline and new-onset kidney disease among Chinese elderly population, and to examine the relationships between baseline SUA, longitudinal change in SUA and rapid eGFR decline over 5 years for a Chinese elderly population with normal kidney function at baseline, which, to our knowledge, has not been explored in the existing literature. The research findings were estimated to supply significant evidence for understanding the process of rapid kidney function decline among a Chinese elderly population, and offer foundation for early targeted prevention and effective geriatric nursing to reduce the occurrence of rapid kidney function decline and new-onset kidney disease for the Chinese elderly population.…”

“…2 Globally, the proportion of elderly population has been increasing dramatically, 8 in particular China's population has 180 million people aged ≥65 years, accounting for 13% of the whole population in 2020. 9 Importantly, compared with the young population, elderly people have a higher incidence of rapid renal function decline and CKD, [10][11][12] which is worthy of more concern and investigation.…”

Alcohol consumption and serum uric acid are synergistically associated with renal dysfunction among community‐dwelling persons

“…A recent meta‐analysis revealed a direct relationship between elevated baseline SUA levels and incident CKD 1 . Longitudinal changes in SUA are interactively and independently associated with declining renal function in community‐dwelling older adults 2 …”