Uric acid is associated with the rate of residual renal function decline in peritoneal dialysis patients.
BACKGROUND
Uric acid (UA) is known to play a pathogenic role in chronic kidney disease (CKD). However, its effect in end-stage renal disease (ESRD) has not yet been elucidated. We explored the prevalence of hyperuricaemia and the relationship between UA and residual renal function (RRF) in peritoneal dialysis (PD) patients.


METHODS
The subjects of this study were 134 PD patients who started dialysis at the Yonsei University Health System between January 2000 and December 2005. Timed urine collections were performed within 1 month of PD commencement and at 6-month intervals thereafter. The slope of decline of RRF over time was calculated by linear regression analysis of serial urinary urea and creatinine clearances for each patient. Biochemical and clinical data at the time of initial urine collection were considered as baseline.


RESULTS
At baseline, 32.8% of the PD patients had hyperuricaemia (UA >or=7.0 mg/dl). A significant majority of patients with hyperuricaemia were diabetic (P = 0.02). Hypertensive patients had a higher UA level (P = 0.002) compared to normotensive patients. The overall reduction rate of RRF in hyperuricaemic patients was significantly higher than in the normouricaemic group (P = 0.001). In the multiple linear regression analysis, hyperuricaemia and history of DM showed a significant negative correlation with the reduction rate of RRF after adjusting for demographic data, comorbid conditions, body mass index, baseline RRF and medications (P = 0.001).


CONCLUSIONS
Hyperuricaemia is common among PD patients and is significantly associated with the rate of decline of RRF.
Park
Jung Tak
JT
Department of Internal Medicine, College of Medicine, Brain Korea 21 for Medical Science, Yonsei University, Seoul, Korea.
Kim
Dong Ki
DK
Chang
Tae Ik
TI
Kim
Hyun Wook
HW
Chang
Jae Hyun
JH
Park
Sun Young
SY
Kim
Eunyoung
E
Kang
Shin-Wook
SW
Han
Dae-Suk
DS
Yoo
Tae-Hyun
TH
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood; D033461:Hyperuricemia / Q000453:epidemiology*; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000097:blood; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D014527:Uric Acid / Q000097:blood
D014527:Uric Acid