Serum uric acid is associated with chronic kidney disease in elderly Chinese patients with diabetes

Abstract

Background The relationship between hyperuricemia and chronic kidney disease (CKD) has been investigated extensively. However, studies on elderly individuals are still limited. Moreover, there is no consensus on whether hyperuricemia or elevated serum uric acid (SUA) within the normal range is correlated with the new onset of CKD and whether there are differences between males and females. Methods We included 39039 elderly diabetic patients without CKD at baseline from a community-based cohort in Wuhan, China. The outcome event was the new onset of CKD (defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m 2 ). Multivariate Cox models were used to assess the adjusted hazard ratio (HR). Results During the 2-year follow-up period, 3162 (8.10%) patients with diabetes developed new-onset CKD. The optimal cutoff value of SUA for incident CKD was 347.4 μmol/L. The adjusted HRs of hyperuricemia for new-onset CKD were 1.925 (1.724–2.150) and 1.676 (1.520–1.848) for males and females, respectively. The risk of developing CKD increased across the Q4 group up to 2.242 times for their counterparts in the lowest SUA quartile, independent of age, sex, diabetes duration, obesity, hypertension, systolic blood pressure, diastolic blood pressure, smoking, drinking, dyslipidemia, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and fasting plasma glucose. Conclusions Hyperuricemia is an independent predictor of incident CKD. Elevated SUA was linearly correlated with CKD in elderly patients with diabetes, showing a relatively higher intensity among males compared with that among females. The optimal cutoff value of SUA for the risk of new-onset CKD in elderly patients with diabetes was 347.4 μmol/L.

Combination Treatment with Verinurad and Allopurinol in CKD

“…The rationale for lowering serum urate concentrations to prevent CKD and its progression is primarily based on both biologic plausibility and findings from observational studies. [23][24][25] There are several biologic pathways through which hyperuricemia may induce early kidney injury, including induction of a specific afferent arteriolar vasculopathy, promotion of endothelial dysfunction through nitric oxide inhibition, and activation of the renin-angiotensin-aldosterone system. 26 Observational studies have found strong associations between hyperuricemia -40 -20 0 and the risk of new-onset kidney disease, 27 while pooled analysis of clinical trial data has suggested that lowering serum urate concentrations resulted in few major kidney events.…”

Exploring multifaceted factors in chronic kidney disease risk: A comprehensive analysis of biochemistry, lifestyle, and inflammation in elderly Chinese individuals

“…The escalating incidence of chronic kidney disease (CKD) in recent years has raised considerable concerns, notably due to its substantial impact on patient mortality rates, rendering it a critical area of study. Given that the importance of UA has been highlighted for both diabetic[ 2 ] and non-diabetic patients[ 3 ], the article endeavors to offer a more comprehensive perspective on the risk factors for CKD. It extends beyond the traditional boundaries of research by incorporating lifestyle and inflammation markers into the analysis, and furthermore, employs cutting-edge machine learning methods, thereby presenting an innovative approach to identifying subjects with abnormal renal function.…”