Relationship between serum uric acid levels with chronic kidney disease in a Southeast Asian population.

AIM: Elevated serum uric level has been suggested as a risk factor for chronic kidney disease (CKD). The relationship between serum uric acid level, and CKD in a Southeast Asian population was examined. METHODS: In a cross-sectional study, authors surveyed 5618 subjects, but 5546 participants were included. The glomerular filtration rate (GFR) values were calculated by the Modification of Diet in Renal Disease (MDRD) equation. CKD was defined as a GFR of less than 60 mL/min per 1.73 m(2). Multivariate binary logistic regression was used to determine the association between serum uric acid level and CKD. RESULTS: The prevalence of CKD in serum uric acid quartiles: first quartile, 5.3 mg/dL or less; second quartile, 5.4-6.4 mg/dL; third quartile, 6.5-7.6 mg/dL; and fourth quartile, 7.7 mg/dL or more were 1.8%, 3.6%, 5.5% and 11.9%, respectively (P < 0.001). The mean values of estimated GFR in participants with CKD and without CKD were 53.44 +/- 7.72 and 81.26 +/- 12.48 mL/min per 1.73 m(2) respectively. In the entire participants, there were 6.76% with hypertension and 2.64% with diabetes as a comorbid disease. Compared with serum uric acid first quartile, the multivariate-adjusted odds for CKD of the fourth, third and second quartile were 10.94 (95% confidence interval (CI), 6.62-16.08), 4.17 (95% CI, 2.51-6.92) and 2.38 (95% CI, 1.43-3.95), respectively. CONCLUSION: High serum uric acid level was independently associated with increased prevalence of CKD in the Southeast Asian population. Detection and treatment of hyperuricaemia should be attended as a strategy to prevent CKD.

High levels of uric acid correlate with decline of glomerular filtration rate in chronic kidney disease.

BACKGROUND: Clinical studies have suggested that high levels of uric acid may contribute to the development of hypertension and kidney disease. However the relation between uric acid and chronic kidney disease (CKD) has been inconsistent. OBJECTIVE: To examine the association between plasma concentration of uric acid, and estimated glomerular filtration rate (GFR) in CKD subjects. MATERIAL AND METHOD: In a cross-sectional study, authors surveyed 5,558 subjects, but only 750 CKD subjects in whom GFR was between 15 and 60 ml/min/1.73 m2 were included in the study. The GFR values were calculated by Cockcroft-Gault formula. RESULTS: There were 65.5% males, mean age of 50.29 +/- 6.39 years and body mass index (BMI) of 21.68 +/- 2.64 kg/m2. The mean value of estimated GFR was 53.86 +/- 6.29 ml/min/1.73 m2. In subjects with serum uric acid fourth quartile displayed significantly higher BMI, higher systolic blood pressure (BP), higher diastolic BP, higher BUN, and higher serum creatinine, and lower estimated GFR as compared with the three lower quartiles. The correlation analysis showed that estimated GFR was negatively correlated with serum uric acid (r = -0.208, p < 0.01), age (r = -0.171, p < 0.01), systolic BP (r = -0.148, p < 0.01) and BMI (r = -0.147, p < 0.01). Multiple regression analysis, the presence of high serum uric acid levels were independently associated with a decline of GFR. CONCLUSION: In CKD subjects, high levels of uric acid were independent associated with GFR decline. Our finding suggests that early detection and prevention on hyperuricemia in CKD subjects are critical.