Relationship of uric acid with progression of kidney disease.
BACKGROUND
Uric acid levels are increased in patients with kidney dysfunction. We tested the hypothesis that uric acid may be associated with kidney disease progression.


METHODS
Cohort study.


METHODS
5,808 participants of the Cardiovascular Health Study.


METHODS
Uric acid levels.


METHODS
Kidney disease progression was defined as a decrease in estimated glomerular filtration rate (GFR) of 3 mL/min/1.73 m(2) per year or greater (>or=0.05 mL/s) and as incident chronic kidney disease (CKD). Measures of kidney function were estimated GFR using the Modification of Diet in Renal Disease Study equation.


RESULTS
Higher quintiles of uric acid levels were associated with greater prevalences of estimated GFR less than 60 mL/min/1.73 m(2) (<1.00 mL/s) of 7%, 14%, 12%, 25%, and 42% for quintiles 1 (<or=4.41 mg/dL [<or=262 micromol/L]), 2 (4.41 to 5.20 mg/dL [262 to 309 micromol/L]), 3 (5.21 to 5.90 mg/dL [310 to 351 micromol/L]), 4 (5.91 to 6.90 mg/dL [352 to 410 micromol/L]), and 5 (>6.90 mg/dL [>410 micromol/L]), respectively. In comparison, there was only a modest, but significant, association between quintiles of uric acid levels and progression of kidney function decrease, with adjusted odds ratios of 1.0, 0.88 (95% confidence interval [CI], 0.64 to 1.21), 1.23 (95% CI, 0.87 to 1.75), 1.47 (95% CI, 1.04 to 2.07), and 1.49 (95% CI, 1.00 to 2.22) for quintiles 1 through 5, respectively. No significant association was found between uric acid level and incident CKD (adjusted odds ratio, 1.00; 95% CI, 0.89 to 1.14).


CONCLUSIONS
Measurements of albuminuria were not available.


CONCLUSIONS
Uric acid levels are associated strongly with prevalent CKD. In comparison, greater uric acid levels had a significant, but much weaker, association with progression of kidney disease.
Chonchol
Michel
M
Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Denver, CO 80262, USA. michel.chonchol@uchsc.edu
Shlipak
Michael G
MG
Katz
Ronit
R
Sarnak
Mark J
MJ
Newman
Anne B
AB
Siscovick
David S
DS
Kestenbaum
Bryan
B
Carney
Jan Kirk
JK
Fried
Linda F
LF
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D008297:Male; D011446:Prospective Studies; D014527:Uric Acid / Q000032:analysis / Q000378:metabolism*
D014527:Uric Acid