Relationship between uric acid levels and risk of chronic kidney disease in a retrospective cohort of Brazilian workers

Abstract

Uric acid (UA) levels are increased in patients with kidney dysfunction. We analyzed the association between asymptomatic hyperuricemia and new-onset chronic kidney disease (CKD). A retrospective cohort study was designed to collect data from employees of an energy generation and distribution company in the city of Rio de Janeiro, Brazil, who had undergone the company’s annual medical checkup from 2008 to 2014. People with ≤2 years of follow-up, with baseline estimated glomerular filtration rate (eGFR) <60 mL·min-1·(1.73 m2)-1 or with incomplete data were excluded. The endpoint was defined as eGFR <60 mL·min-1·(1.73 m2)-1 estimated through the chronic kidney disease epidemiology collaboration equation (CKD-EPI). The study included 1094 participants. The mean follow-up period was 5.05±1.05 years and 44 participants exhibited new-onset CKD. The prevalence of hyperuricemia was 4.2%. There was a significant inverse correlation between baseline serum levels of UA and baseline eGFR (R=-0.21, P<0.001). Female gender (OR=4.00; 95%CI=1.92-8.29, P<0.001) and age (OR=1.06; 95%CI=1.02-1.11, P=0.004) but not UA levels (OR=1.12; 95%CI=0.83-1.50; P=0.465) were associated with new-onset CKD. Diabetes mellitus and body mass index were independent factors for fast progression (OR=2.17; 95%CI=1.24-3.80, P=0.007 and OR=1.04; 95%CI=1.01-1.07; P=0.020). These results did not support UA as an independent predictor for CKD progression in the studied population.

Genetically Elevated Serum Uric Acid and Renal Function in an Apparently Healthy Population

“…Meanwhile, consistent with previous studies [4][5][6][7][8][9][10][11][12], we found that uric acid levels were negatively correlated with eGFR in all subjects. In the regression analysis, various potential confounders were added in sequential order, but the results revealed only a modest reduction effect (the regression coefficient changed from -0.20 to -0.22 after adjusting for a range of confounders), strengthening the notion of a relationship between uric acid and eGFR.…”

“…The association between uric acid and kidney disease has been previously investigated. Numerous studies reported a positive association between the levels of circulating uric acid and the risk of CKD progression [4][5][6][7][8][9][10][11][12], but this was negated in other studies [13][14][15]. Observational studies experience residual problems of poorly measured or unmeasured confounding factors and reverse causality when the disease process has a long latency period.…”

Hyperuricemia induces lipid disturbances mediated by LPCAT3 upregulation in the liver

“…Hyperuricemia or high serum uric acid (SUA) levels have been linked to obesity, 1,2 fatty liver, type 2 diabetes, 3 and renal injury 4 . Moreover, research has indicated a contributory role of uric acid (UA) in metabolic syndrome, which is characterized by dyslipidemia, insulin resistance, and hypertension 5 .…”

Chronic kidney disease in adults aged 18 years and older in Chile: findings from the cross-sectional Chilean National Health Surveys 2009–2010 and 2016–2017

“… 28 Moreover, there are several studies showing that diabetes is associated with the development of increased albuminuria and faster progression of CKD. 28 30–32 Evidence from other Latin American countries 30–32 suggests that diabetes and worse glycaemic control are significant predictors for increased albuminuria, faster progression of CKD and need for RRT. On the other hand, a meta-analysis which analysed the risk factors for development and progression of CKD, showed that diabetes was marginally predictive of progression from late-stage CKD to ESKD (HR: 1.16, 95% CI: 0.98 to 1.38; p = 0.08).…”