Background Hyperuricemia is a very common biochemical finding associated with aging, hypertension, chronic kidney disease (CKD), and cardiovascular disease. Nevertheless, the evidence for a causal link between hyperuricemia and these disorders is still controversial.
Objective To investigate the prognostic properties of uric acid for renal function decrement and early chronic kidney disease (CKD) in community-dwelling populations with normal renal function at baseline.
Methods From September 2007 to January 2009, a total of 1 394 subjects with estimated glomerular filtration rate (eGFR) > 60 mL/(min·1.73 m2) (45-96 years, 753 females) were recruited from a community-based population in Beijing. Participants were divided into three groups according to baseline uric acid levels, with 465 subjects in ≤ 254.5 μmol/L group (group A), 465 subjects in 254.6-318.0 μmol/L group (group B), 464 subjects in ≥ 318.1 μmol/L group (group C). The baseline data were collected and eGFR were calculated. The follow-up lasted for 4.5-5.2 (4.8 ± 0.9) years with the last follow-up of September 2013. The main outcomes were the rapid eGFR decline and the new incidence of CKD.
Results At the end of follow-up, the mean eGFR decreased from 94.42 ± 14.25 mL/(min·1.73 m2) to 86.00 ± 15.57 mL/(min·1.73 m2), and the incidence of rapid eGFR decline and CKD were 21.7% and 6.0%, respectively. In multivariate linear regression analysis, age, BMI, uric acid, and concentration of homocysteine were independent determinants of the change in renal function. After adjusting for various confounders, uric acid was independently associated with the rapid eGFR decline. Compared with subjects in group A, subjects in group C demonstrated a stronger correlation of CKD (OR: 1.699, 95% CI: 1.167-2.473, P=0.006). Baseline uric acid levels were also independently associated with new occurrence of CKD (HR=2.526, 95% CI: 1.366-4.671, P=0.003).
Conclusion The study shows that uric acid is an independent predictor of the decline in renal function.
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