J Korean Med Sci.  2013 Jun;28(6):855-860. 10.3346/jkms.2013.28.6.855.

The Association between Uric Acid and Chronic Kidney Disease in Korean Men: A 4-Year Follow-up Study

Affiliations
  • 1Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
  • 2Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3The Korea Central Cancer Registry, National Cancer Center, Goyang, Korea.
  • 4Department of Occupational and Environmental Medicine, Dongguk University, Gyeongju Hospital, Gyeongju, Korea. searchthing@naver.com

Abstract

There have been many studies between serum uric acid (UA) and chronic kidney disease (CKD). However, as far as we know, little research has been done to examine the prospective association between serum UA and development of CKD in Korean men. This prospective cohort study was performed using 18,778 men who participated in a health checkup program both on January, 2005 and on December, 2009. CKD was defined as an estimated glomerular filtration rate < 60 mL/min per 1.73 m2. The odds ratio (OR) from binary logistic regressions for the development of CKD was determined with respect to the quintiles grouping based on serum UA. During 74,821.4 person-years of follow-up, 110 men were found to develop CKD. The OR for the development of CKD increased as the quintiles for baseline serum UA levels increased from the first to fifth quintiles (1.00 vs 1.22, 1.19, 2.59, and 3.03, respectively, p for linear trend < 0.001) after adjusting for covariates. The adjusted OR comparing those participants with hyperuricemia ( > or = 7.0 mg/dL) to those with normouricemia ( < 7.0 mg/dL) was 1.96 (1.28-2.99). Elevated serum UA levels were independently associated with increased likelihood for the development of CKD in Korean men (IRB number: KBC10034).

Keyword

Uric Acid; Kidney Failure, Chronic

MeSH Terms

Adult
Age Factors
Alcohol Drinking
Asian Continental Ancestry Group
Blood Pressure
Body Mass Index
Cohort Studies
Follow-Up Studies
Glomerular Filtration Rate
Humans
Hyperuricemia/etiology
Insulin Resistance
Logistic Models
Male
Middle Aged
Odds Ratio
Prospective Studies
Renal Insufficiency, Chronic/*blood/complications/diagnosis
Republic of Korea
Smoking
Triglycerides/blood
Uric Acid/*blood
Triglycerides
Uric Acid

Figure

  • Fig. 1 Selection of study participants.


Reference

1. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004. 351:1296–1305.
2. Kiberd B. The chronic kidney disease epidemic: stepping back and looking forward. J Am Soc Nephrol. 2006. 17:2967–2973.
3. Weiner DE, Tighiouart H, Amin MG, Stark PC, MacLeod B, Griffith JL, Salem DN, Levey AS, Sarnak MJ. Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: a pooled analysis of community-based studies. J Am Soc Nephrol. 2004. 15:1307–1315.
4. Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA. 2004. 291:844–850.
5. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002. 39:S1–S266.
6. Nagahama K, Inoue T, Iseki K, Touma T, Kinjo K, Ohya Y, Takishita S. Hyperuricemia as a predictor of hypertension in a screened cohort in Okinawa, Japan. Hypertens Res. 2004. 27:835–841.
7. Sundström J, Sullivan L, D'Agostino RB, Levy D, Kannel WB, Vasan RS. Relations of serum uric acid to longitudinal blood pressure tracking and hypertension incidence. Hypertension. 2005. 45:28–33.
8. Ejerblad E, Fored CM, Lindblad P, Fryzek J, McLaughlin JK, Nyrén O. Obesity and risk for chronic renal failure. J Am Soc Nephrol. 2006. 17:1695–1702.
9. Hsu CY, McCulloch CE, Iribarren C, Darbinian J, Go AS. Body mass index and risk for end-stage renal disease. Ann Intern Med. 2006. 144:21–28.
10. Iseki K, Ikemiya Y, Kinjo K, Inoue T, Iseki C, Takishita S. Body mass index and the risk of development of end-stage renal disease in a screened cohort. Kidney Int. 2004. 65:1870–1876.
11. Fukui M, Tanaka M, Shiraishi E, Harusato I, Hosoda H, Asano M, Kadono M, Hasegawa G, Yoshikawa T, Nakamura N. Serum uric acid is associated with microalbuminuria and subclinical atherosclerosis in men with type 2 diabetes mellitus. Metabolism. 2008. 57:625–629.
12. Nakagawa T, Kang DH, Feig D, Sanchez-Lozada LG, Srinivas TR, Sautin Y, Ejaz AA, Segal M, Johnson RJ. Unearthing uric acid: an ancient factor with recently found significance in renal and cardiovascular disease. Kidney Int. 2006. 69:1722–1725.
13. Liu PW, Chang TY, Chen JD. Serum uric acid and metabolic syndrome in Taiwanese adults. Metabolism. 2010. 59:802–807.
14. Klein BE, Klein R, Lee KE. Components of the metabolic syndrome and risk of cardiovascular disease and diabetes in Beaver Dam. Diabetes Care. 2002. 25:1790–1794.
15. Weiner DE, Tighiouart H, Elsayed EF, Griffith JL, Salem DN, Levey AS. Uric acid and incident kidney disease in the community. J Am Soc Nephrol. 2008. 19:1204–1211.
16. Obermayr RP, Temml C, Gutjahr G, Knechtelsdorfer M, Oberbauer R, Klauser-Braun R. Elevated uric acid increases the risk for kidney disease. J Am Soc Nephrol. 2008. 19:2407–2413.
17. Iseki K, Ikemiya Y, Inoue T, Iseki C, Kinjo K, Takishita S. Significance of hyperuricemia as a risk factor for developing ESRD in a screened cohort. Am J Kidney Dis. 2004. 44:642–650.
18. Chonchol M, Shlipak MG, Katz R, Sarnak MJ, Newman AB, Siscovick DS, Kestenbaum B, Carney JK, Fried LF. Relationship of uric acid with progression of kidney disease. Am J Kidney Dis. 2007. 50:239–247.
19. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985. 28:412–419.
20. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009. 150:604–612.
21. Johnson RJ, Rideout BA. Uric acid and diet: insights into the epidemic of cardiovascular disease. N Engl J Med. 2004. 350:1071–1073.
22. Sturm G, Kollerits B, Neyer U, Ritz E, Kronenberg F. MMKD Study Group. Uric acid as a risk factor for progression of non-diabetic chronic kidney disease? the Mild to Moderate Kidney Disease (MMKD) Study. Exp Gerontol. 2008. 43:347–352.
23. Madero M, Sarnak MJ, Wang X, Greene T, Beck GJ, Kusek JW, Collins AJ, Levey AS, Menon V. Uric acid and long-term outcomes in CKD. Am J Kidney Dis. 2009. 53:796–803.
24. Zoccali C, Maio R, Mallamaci F, Sesti G, Perticone F. Uric acid and endothelial dysfunction in essential hypertension. J Am Soc Nephrol. 2006. 17:1466–1471.
25. Sánchez-Lozada LG, Tapia E, Santamaría J, Avila-Casado C, Soto V, Nepomuceno T, Rodríguez-Iturbe B, Johnson RJ, Herrera-Acosta J. Mild hyperuricemia induces vasoconstriction and maintains glomerular hypertension in normal and remnant kidney rats. Kidney Int. 2005. 67:237–247.
26. Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function: measured and estimated glomerular filtration rate. N Engl J Med. 2006. 354:2473–2483.
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