Association of uric acid with change in kidney function in healthy normotensive individuals.
BACKGROUND
Despite recent evidence, the role of uric acid as a causal factor in the pathogenesis and progression of kidney disease remains controversial, partly because of the inclusion in epidemiologic studies of patients with hypertension, diabetes, and/or proteinuria.


METHODS
Prospective observational cohort.


METHODS
900 healthy normotensive adult blood donors (153 women, 747 men) evaluated at baseline and after 5 years.


METHODS
Serum uric acid level.


RESULTS
Decrease in estimated glomerular filtration rate (eGFR) >10 mL/min/1.73 m(2), computed using the Modification of Diet in Renal Disease (MDRD) Study equation, with secondary analyses examining similar decreases using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Cockcroft-Gault equations.


RESULTS
During a median follow-up of 59 months, eGFR decreased from 97 +/- 16 to 88 +/- 14 mL/min/1.73 m(2). Higher serum uric acid levels were associated with a greater likelihood of eGFR decrease in both women and men (HR, 1.13 [95% CI, 1.04-1.39] per each 1-mg/dL increase in uric acid level); in multivariable analyses adjusting for age, sex, body mass index, blood glucose level, total cholesterol level, mean blood pressure, urine albumin-creatinine ratio, and serum triglyceride level, the association remained highly significant (HR, 1.28 [95% CI, 1.12-1.48]). Results were similar using different estimating equations and when the association was examined in sex-specific subgroups.


CONCLUSIONS
Analyses were based on a single baseline uric acid measurement. Women are underrepresented.


CONCLUSIONS
In healthy normotensive individuals, serum uric acid level is an independent risk factor for decreased kidney function.
Bellomo
Gianni
G
Department of Nephrology, San Giovanni Battista Hospital, Foligno, Pg, Italy. bellomopg@tin.it
Venanzi
Sandro
S
Verdura
Claudio
C
Saronio
Paolo
P
Esposito
Antonella
A
Timio
Mario
M
D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000503:physiopathology; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
D014527:Uric Acid; D003404:Creatinine