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

  • 1Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
  • 2Department of Rheumatology, Keimyung University Dongsan Medical Center, Daegu, Korea
  • 3Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
  • 4Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea


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.
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.
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).
The OR of reduced renal function according to uric acid levels formed a J-shaped curve in both genders.


Chronic kidney diseases; Hyperuricemia; Uric acid
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