Uric acid is not associated with decline in renal function or time to renal replacement therapy initiation in a referred cohort of patients with Stage III, IV and V chronic kidney disease

Nacak, Hakan; Diepen, Merel van; Qureshi, Abdul Rashid; Carrero, Juan Jesús; Stijnen, Theo; Dekker, Friedo W.; Evans, Marie

doi:10.1093/ndt/gfv225

Cited by 36 publications

(35 citation statements)

References 56 publications

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“…Although some studies showed no association between hyperuricemia and the progression of CKD [10–14], other studies found hyperuricemia may hasten the failing of renal function measured by eGFR or increase the risk of developing ESRD(Table 4) [31–42]. Among 63,758 subjects with baseline eGFR ≥ 60 ml/min/1.73 m 2 , the subjects with hyperuricemia had an average annual decline of eGFR of 2.5 ± 9.5 mL/min/1.73 m 2 , that was almost twice faster than those of patients with normal uric acid levels [31].…”

Section: Discussionmentioning

confidence: 99%

“…Although a recent meta-analysis found that elevated serum UA levels were associated with incident CKD [9], the role of UA in CKD progression is still debating. For instance, results from a large cohort of the Swedish Renal Registry showed neither the rate of estimated glomerular filtration rate (eGFR) decline nor rapid progression to end stage renal disease (ESRD) was associated with serum UA levels in patients with CKD stage 3 to 5 [10]. This finding is concordant with some recent observational studies of patients with a wide range of renal function at baseline in the U.S. [11], Taiwan [12], and Europe (Germany, Austria, south Tyrol, and Netherlands)[13, 14].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Serum Uric Acid and Progression of Kidney Disease: A Longitudinal Analysis and Mini-Review

Tsai¹,

Lin²,

Kuo³

et al. 2017

PLoS ONE

148

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BackgroundIncreasing evidence supports the association between hyperuricemia and incident chronic kidney disease (CKD); however, there are conflicting data regarding the role of hyperuricemia in the progression of CKD. This study retrospectively assessed the longitudinal association between uric acid (UA) level and CKD progression in a Chinese population lived in Taiwan.MethodsPatients with physician diagnosis of hyperuricemia or receiving urate-lowering therapy between 2003 and 2005 were identified in the electronic medical records (EMR) of a tertiary medical center and were followed up until December 31, 2011. Patients were divided into four UA categories at the cut-off 6, 8, and 10 mg/dL. CKD progression was estimated by the change of estimated glomerular filtration rate (eGFR) in the linear mixed models. Kidney failure was defined as an eGFR less than 15 mL/min/1.73 m2 or requiring renal replacement therapy.ResultsA total of 739 patients were analyzed. In the full-adjusted model, patients with a baseline UA level ≥6 mg/dL had greater decline in eGFR ((β = -9.6, 95% CI -16.1, -3.1), comparing to those with a UA level less than 6 mg/dL. When stratifying patients into four UA categories, all three hyperuricemia categories (UA6-8, 8–10, ≥10 mg/dL) associated with a greater decline in eGFR over the follow-up period with an increasing dose-response, comparing to the lowest UA category. The risk of progression to renal failure increased 7% (hazard ratio 1.07, 95% CI 1.00, 1.14) for each 1mg/dL increase in baseline UA level. The influences of hyperuricemia on eGFR decline and the risk of kidney failure were more prominent in patients without proteinuria than those with proteinuria.ConclusionOur study showed a higher uric acid level is associated with a significant rapid decline in eGFR and a higher risk of kidney failure, particularly in patients without proteinuria. Our findings suggest hyperuricemia is a potential modifiable factor of CKD progression.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serum Uric Acid and Progression of Kidney Disease: A Longitudinal Analysis and Mini-Review

Tsai¹,

Lin²,

Kuo³

et al. 2017

PLoS ONE

148

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“…The association between high serum uric acid (UA) and progression of CKD was suggested by many studies of stage G1 and G2 [97][98][99] . A more recent study denied this association in stages G3, 4 and 5 [100] . On the other hand, hyperuricemia was found as independent risk factor for CKD progression in children and adolescents [101] .…”

Section: Pathogenesismentioning

confidence: 92%

Stop chronic kidney disease progression: Time is approaching

Din¹,

Salem²,

Abdulazim³

2016

WJN

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Progression of chronic kidney disease (CKD) is inevitable. However, the last decade has witnessed tremendous achievements in this field. Today we are optimistic; the dream of withholding this progression is about to be realistic. The recent discoveries in the field of CKD management involved most of the individual diseases leading the patients to end-stage renal disease. Most of these advances involved patients suffering diabetic kidney disease, chronic glomerulonephritis, polycystic kidney disease, renal amyloidosis and chronic tubulointerstitial disease. The chronic systemic inflammatory status and increased oxidative stress were also investigated. This inflammatory status influences the antisenescence Klotho gene expression. The role of Klotho in CKD progression together with its therapeutic value are explored. The role of gut as a major source of inflammation, the pathogenesis of intestinal mucosal barrier damage, the role of intestinal alkaline phosphatase and the dietary and therapeutic implications add a novel therapeutic tool to delay CKD progression.

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“…Можна розгля-нути, наприклад, результати аналізу історичної ко-горти японських чоловіків, які пройшли медичне обстеження в період з 1998 по 2007 р. Включені були учасники, які мали вихідні обстеження, знаходилися під наглядом не менше 1 року і були розподілені від-повідно до вихідної функції нирок. Ниркова функ-ція була класифікована як збережена (розрахована ШКФ більше 90 мл/хв/1,73 м 2 ) або помірно зниже-¹ 1 (15) Аналіз даних Шведського ниркового реєстру хронічної хвороби нирок SRR-CKD, в якому було проаналізовано результати обстежень 2466 пацієн-тів, оглянутих з 2005 по 2011 р., із середнім часом спостереження 26 місяців, показує відсутність ста-тистично значимої зміни в середньому зниженні ШКФ при кожному збільшенні рівня сечової кис-лоти на 1 мг/дл (59 мкмоль/л) порівняно з вихідним рівнем, а також відсутність зв'язку між збільшенням рівня сечової кислоти на 1 мг/дл (59 мкмоль/л) по-рівняно з вихідним рівнем і початком нирково-за-місної терапії у пацієнтів з ІІІ-V стадіями хронічної хвороби нирок [15].…”

Section: Looking At the Problemunclassified

Сечова Кислота І Її Роль У Прогресуванні ХХН: Чи Достатньо Ми Знаємо?

Savytska

2021

KIDNEYS

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Uric acid is not associated with decline in renal function or time to renal replacement therapy initiation in a referred cohort of patients with Stage III, IV and V chronic kidney disease

Abstract: UA is not associated with the rate of decline in renal function or time to start of RRT in Stage III, IV and/or V CKD patients.

Cited by 36 publications

References 56 publications

Serum Uric Acid and Progression of Kidney Disease: A Longitudinal Analysis and Mini-Review

Serum Uric Acid and Progression of Kidney Disease: A Longitudinal Analysis and Mini-Review

Stop chronic kidney disease progression: Time is approaching

Сечова Кислота І Її Роль У Прогресуванні ХХН: Чи Достатньо Ми Знаємо?

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