- Hyperuricemia is associated with an increased risk of renal failure and death in patients with earlier stages of chronic kidney disease (CKD).
Why this matters
- Uric acid concentration may have more relevance for patients with preserved renal function.
- Chronic Renal Insufficiency Cohort multicenter prospective study of 3885 patients with stage II-IV CKD.
- Mean baseline estimated glomerular filtration rate (eGFR) was 44.3±15.0 mL/min/1.73 m2.
- Funding: National Institute of Diabetes and Digestive and Kidney Diseases; National Heart, Lung, and Blood Institute.
- Over a median 7.9-year follow-up, 885 patients progressed to renal failure and 789 died.
- Multivariate analysis showed that each standard deviation (SD) increase in baseline uric acid was tied to a 40% increased risk for renal failure in stage II/IIIa CKD (eGFR ≥45 mL/min/1.73 m2 [aHR, 1.40; 95% CI, 1.12-1.75]).
- In CKD stage IIIb (eGFR 30-44 mL/min/1.73 m2), the risk was nominally higher but did not achieve statistical significance (aHR, 1.13; 95% CI, 0.99-1.29); no increased risk was observed in stage IV CKD.
- Data showed a J-shaped curve (P=.007) between baseline uric acid and all-cause mortality after adjustment for demographic factors, comorbidities, medication, and laboratory findings (including eGFR).
- Observational data cannot prove causality.