J Rheum Dis.  2021 Oct;28(4):225-233. 10.4078/jrd.2021.28.4.225.

J-shaped Relationship Between Chronic Kidney Disease and Serum Uric Acid Levels: A Cross-sectional Study on the Korean Population

• Koo BS
• Jeong HJ
• Son CN
• Kim SH
• Kim GH
• Jun JB

• KMID: 2520435
• DOI: http://doi.org/10.4078/jrd.2021.28.4.225

Abstract

Objective
Both hypouricemia and hyperuricemia are reportedly associated with reduced kidney function. This study investigated the association between uric acid levels and the risk of reduced renal function in men and women.
Methods
We conducted a cross-sectional study using data from a government-funded health examinee cohort of a Korean genome and epidemiological study. A total of 172,970 participants (58,981 men, 113,989 women) aged 40∼79 years were included. A logistic regression test was performed, and the odds ratio (OR) and 95% confidence interval (CI) were calculated to examine the relationship between stratified uric acid levels and the frequency of chronic kidney disease.
Results
As the uric acid level increased, the risk of reduced renal function increased. Moreover, for uric acid levels ≤2.0 mg/dL, the risk of reduced renal function was higher than that of the reference group. Among the total, man, and woman groups, a statistically significant association was observed in men (OR 1.71, 95% CI 0.945∼3.111, OR 5.003, 95% CI 1.405∼17.809, and OR 1.377, 95% CI 0.696∼2.724, respectively).
Conclusion
The OR of reduced renal function according to uric acid levels formed a J-shaped curve in both genders.

Keyword

Chronic kidney diseases; Hyperuricemia; Uric acid

Figure

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  Figure 1 Relationship between serum uric acid levels and eGFR. MDRD: Modification of Diet in Renal Disease, eGFR: estimated glomerular filtration rate.

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  Figure 2 Prevalence of reduced renal function according to serum uric acid levels. MDRD: Modification of Diet in Renal Disease, eGFR: estimated glomerular filtration rate, UA: uric acid level.

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  Figure 3 Prevalence of reduced renal function according to percentiles of serum uric acid levels (5th, 20th, 80th, and 95th). MDRD: Modification of Diet in Renal Disease, eGFR: estimated glomerular filtration rate, Q1: first quartile, Q2: second quartile, Q3: third quartile, Q4: fourth quartile, Q5: fifth quartile.

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  Figure 4 The odd ratio of reduced renal function in total, men, and women participants according to uric acid level.

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