The Effects of Hyperuricemia on the Prognosis of IgA Nephropathy are More Potent in Females

Oh, Tae Ryom; Choi, Hong Sang; Kim, Chang Seong; Kang, Kyung Pyo; Kwon, Young Joo; Kim, Sung Gyun; Kwon, Seong; Kim, Soo Wan; Bae, Eun Hui

doi:10.3390/jcm9010176

Cited by 19 publications

(16 citation statements)

References 46 publications

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“…The AUC for male patients was 0.5728 ± 0.2029 ( Figure 4C). Our results revealed that the SUA level was a valuable indicator in predicting the prognosis of IgAN patients, especially in female patients, which is consistent with the research of Oh et al (Oh et al 2020).…”

Section: The Value Of the Sua Level In Predicting Renal Prognosissupporting

confidence: 93%

Peer Review #3 of "Serum uric acid level is correlated with the clinical, pathological progression and prognosis of IgA nephropathy: an observational retrospective pilot-study (v0.1)"

2020

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This study was aimed to assess the relationship between serum uric acid (SUA) level and the clinical, pathological phenotype of IgA nephropathy (IgAN), and to determine the role of SUA level in the progression and prognosis of IgAN. Methods. A total of 208 patients with IgAN were included in this study, which was classified into the normo-uricemia group and hyperuricemia group according to the SUA level. The clinical data at baseline, IgA Oxford classification scores (MEST-C scoring system), and other pathological features were collected and further analyzed. All patients were followed up and the prognosis was assessed using Kaplan-Meier survival curves. GraphPad Prism 7.0 and SPSS 23.0 were used for statistical analyses. Results. In clinical indicators, patients with hyperuricemia had the significantly higher proportion of males to females, mean arterial pressure, the levels of total cholesterol, triglyceride, Scr, BUN, 24 hoururine protein, C3, and C4, the lower levels of high-density lipoprotein cholesterol and eGFR than those without(p<0.05). In terms of pathological characteristics, the tubular atrophy/interstitial fibrosis scores, vascular injury scores, and glomerular sclerosis percentage were significantly higher in patients with hyperuricemia compared with those without(p<0.01). There was no significant difference in the scores of mesangial hypercellularity, endocapillary hypercellularity, focal segmental glomerulosclerosis, as well as crescents between the two groups(p>0.05). As for the depositions of immune complexes deposition in IgAN, the hyperuricemia group had less deposition of immunoglobulin G and FRA than the normouricemia group (p<0.05), while the deposition of immunoglobulin A, immunoglobulin M, and complement C3 in the two groups showed no statistical difference. The survival curve suggested that patients in the hyperuricemia group have significantly poorer renal outcome than those in the normo-uricemia group (p= 0.0147). Results also revealed that the SUA level is a valuable predictor of renal outcome in patients with IgAN. The optimal cutoff value was 361.1μmol/L (AUC=0.76±0.08167) and 614 μmol/L (AUC=0.5728±0.2029) for female and male, respectively. Conclusions. The level of SUA is associated with renal function level and pathological severity of IgAN, and maybe a prognostic indicator of IgAN.

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Section: The Value Of the Sua Level In Predicting Renal Prognosissupporting

confidence: 93%

Peer Review #3 of "Serum uric acid level is correlated with the clinical, pathological progression and prognosis of IgA nephropathy: an observational retrospective pilot-study (v0.1)"

2020

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“…4C). Our results revealed that the SUA level was a valuable indicator in predicting the prognosis of IgAN patients, especially in female patients, which is consistent with the research of Oh et al (2020).…”

Section: The Value Of the Sua Level In Predicting Renal Prognosissupporting

confidence: 90%

Serum uric acid level is correlated with the clinical, pathological progression and prognosis of IgA nephropathy: an observational retrospective pilot-study

Zhu

et al. 2020

PeerJ

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Objectives This study was aimed to assess the relationship between serum uric acid (SUA) level and the clinical, pathological phenotype of IgA nephropathy (IgAN), and to determine the role of SUA level in the progression and prognosis of IgAN. Methods A total of 208 patients with IgAN were included in this study, and were classified into the normo-uricemia group and hyperuricemia group according to the SUA level. The clinical data at baseline, IgAN Oxford classification scores (MEST-C scoring system), and other pathological features were collected and further analyzed. All patients were followed up and the prognosis was assessed using Kaplan-Meier survival curves. GraphPad Prism 7.0 and SPSS 23.0 were used for statistical analyses. Results In clinical indicators, patients with hyperuricemia had the significantly higher proportion of males to females, mean arterial pressure, the levels of total cholesterol, triglyceride, Scr, BUN, 24 hour-urine protein, C3, and C4, the lower levels of high-density lipoprotein cholesterol and eGFR than those without (p < 0.05). In terms of pathological characteristics, the tubular atrophy/interstitial fibrosis scores, vascular injury scores, and glomerular sclerosis percentage were significantly higher in patients with hyperuricemia compared with those without (p < 0.01). There was no significant difference in the scores of mesangial hypercellularity, endocapillary hypercellularity, focal segmental glomerulosclerosis, as well as crescents between the two groups (p > 0.05). As for the depositions of immune complexes deposition in IgAN, the hyperuricemia group had less deposition of immunoglobulin G and FRA than the normo-uricemia group (p < 0.05), while the deposition of immunoglobulin A, immunoglobulin M, and complement C3 in the two groups showed no statistical difference. The survival curve suggested that patients in the hyperuricemia group have significantly poorer renal outcome than those in the normo-uricemia group (p = 0.0147). Results also revealed that the SUA level is a valuable predictor of renal outcome in patients with IgAN. The optimal cutoff value was 361.1 µmol/L (AUC = 0.76 ± 0.08167) and 614 µmol/L (AUC = 0.5728 ± 0.2029) for female and male, respectively. Conclusions The level of SUA is associated with renal function level and pathological severity of IgAN, and maybe a prognostic indicator of IgAN.

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“…Comparable findings were also reported in a study conducted in Japan showing increased serum uric acid among the smoking population 14 . Although the reason for the positive association between smoking exposure and hyperuricemia only in women is unclear, prominent renal function declining in women with IgA nephritis might, at least partly, be related to this finding 21 . In addition, metabolic impairment due to smoking exposure could play a significant role in the risk for hyperuricemia, which is different between women and men 22 .…”

Section: Discussionmentioning

confidence: 96%

Association of urinary cotinine-verified smoking status with hyperuricemia: Analysis of population-based nationally representative data

Kim¹,

Kang²

2020

Tob. Induc. Dis.

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chronic kidney disease 5 , premature death from cardiovascular disease 6 , and overall mortality 7 ; thus, the increasing prevalence of hyperuricemia, especially in women, is drawing increasing attention in public health owing to its implications for chronic diseases 8. Serum uric acid levels are determined by the interplay of genetic and environmental factors. Several genetically-susceptible loci including solute ABSTRACT INTRODUCTION Smoking status based solely on self-reporting is unreliable and might be inaccurate, particularly among women. This study investigated the association between urinary cotinine-verified smoking status and hyperuricemia in a nationwide Korean population. METHODS This study included 5329 participants aged ≥19 years with information on smoking status, urine cotinine levels and serum uric acid. We determined smoking status according to self-reports and urinary cotinine levels. Multivariate linear regression analysis was used to measure the association between smoking exposure and serum uric acid levels. The effects of smoking on hyperuricemia were evaluated by multivariate logistic regression analysis. RESULTS Biochemically verified active and passive smokers comprised 22% (38.7% of men and 8.8% of women) and 12.3% (11.9% of men and 12.6% of women) of the study population, respectively. While reclassification rate of active smokers was 1.4% in men, 31.8% of cotinine-verified female active smokers were self-reported never smokers. Higher uric acid levels were observed with increased tobacco exposure among women (p-trend=0.007) but not among men. After adjusting for confounders, the risk of hyperuricemia increased with tobacco exposure only in women (p-trend=0.016). CONCLUSIONS Cotinine-verified smoking status was associated with increased serum uric acid and hyperuricemia in a dose-response manner only in women. This study might provide evidence to support the importance of smoking cessation in women with gout and further studies are necessary to elucidate the underlying mechanism of the observed association.

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The Effects of Hyperuricemia on the Prognosis of IgA Nephropathy are More Potent in Females

Cited by 19 publications

References 46 publications

Peer Review #3 of "Serum uric acid level is correlated with the clinical, pathological progression and prognosis of IgA nephropathy: an observational retrospective pilot-study (v0.1)"

Peer Review #3 of "Serum uric acid level is correlated with the clinical, pathological progression and prognosis of IgA nephropathy: an observational retrospective pilot-study (v0.1)"

Serum uric acid level is correlated with the clinical, pathological progression and prognosis of IgA nephropathy: an observational retrospective pilot-study

Association of urinary cotinine-verified smoking status with hyperuricemia: Analysis of population-based nationally representative data

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