Impact of Serum Uric Acid Levels on Rapid Renal Deterioration in Subjects With Normal Renal Function: A Prospective Community-Based Study

Chun-Chieh Chang ； Heng-Chih Pan ； Yu-Chi Kuo ； Chiao-Yin Sun ； Heng-Jung Hsu ； I-Wen Wu ； Chin-Chan Lee

《Acta Nephrologica》 32卷3期 (2018/09) Pp. 108-117

https://doi.org/10.6221/AN.201809_32(3).0003

摘要

BACKGROUND: Hyperuricemia is always noted in patients with chronic kidney disease. However, the impact of asymptomatic hyperuricemia on the rapid deterioration of renal function in healthy people is still controversial. The aim of this study was to explore the association between asymptomatic hyperuricemia and a rapid decline in glomerular filtration rate (GFR) in subjects with normal renal function. METHODS: This longitudinal, community-based cohort study was conducted at four districts in northeastern Taiwan. The demographic parameters, clinical variables, blood, and urine samples of 1,718 gout-free subjects were collected from August 2013 to June 2015. Normal renal function was defined as an estimated GFR (eGFR) ≥ 90 mL/min/1.73 m^2 and a urine protein-creatinine ratio (UACR) ＜ 30 mg/g, and abnormal renal function was defined as an eGFR ＜ 90 mL/min/1.73 m^2 or UACR ≥ 30 mg/g. Rapid progression was defined as ≥ 30% decrease in eGFR per year, and an eGFR decrease ＜ 30% was defined as non-rapid progression. The characteristics of those with rapid and non-rapid progression were compared among the overall population, normal renal function group, and abnormal renal function group. The significant factors associated with rapid progression were then examined using univariate analysis followed by multivariate logistic regression analysis in the subjects with normal and abnormal renal function. RESULTS: Eight hundred and ninety-five participants with normal renal function were enrolled in this study. In these subjects with normal renal function, the prevalence of eGFR rapid progression was 2.0% (18/895), and hyperuricemia was significantly associated with eGFR rapid progression. Multiple logistic regression analysis further indicated that hyperuricemia and baseline eGFR were significant factors for rapid renal progression in the subjects with normal renal function. CONCLUSION: Our study demonstrated that asymptomatic hyperuricemia and baseline eGFR were independent risk factors for rapid renal function progression in subjects with normal renal function. Serum uric acid levels should be measured during routine check-ups of healthy adults.

關鍵字

asymptomatic hyperuricemia ； gout-free ； rapid renal progression ； normal renal function population ； uric acid