title: The relationship between serum uric acid and chronic kidney disease among Appalachian adults.
abstract: BACKGROUND
  Higher serum uric acid (SUA) levels have been shown to be associated with cardiovascular disease. SUA levels are also associated with hypertension, a strong risk factor for chronic kidney disease (CKD). However, it is unclear whether SUA is independently associated with CKD. We examined the hypothesis that higher SUA levels are positively associated with CKD.
  
  
  METHODS
  We analysed data from the C8 Health Study, a population-based study of Appalachian adults aged ≥18 years and free of cardiovascular disease (n = 49,295, 53% women). SUA was examined as gender-specific quartiles. The outcome of interest was CKD (n = 2,980), defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m(2) from serum creatinine.
  
  
  RESULTS
  Overall, we observed a clear positive association between increasing quartiles of SUA and CKD, independent of confounders. Compared with the lowest quartile of SUA (referent), the multivariable odds ratios (95% confidence interval) for quartiles 2-4, respectively, of CKD were 1.53 (1.31, 1.78), 2.16 (1.86 2.50) and 4.67 (4.07, 5.36); P-trend < 0.0001. This observed positive association persisted in separate analysis among men (P-trend < 0.0001) and women (P-trend < 0.0001).
  
  
  CONCLUSIONS
  In conclusion, higher SUA levels are positively associated with CKD, suggesting that at least part of the reported association between SUA and cardiovascular disease may be mediated by CKD.
authors.affiliation: Department of Community Medicine, West Virginia University School of Medicine, Morgantown, WV 26506-9190, USA.
authors.forename: Loretta
authors.initials: L
authors.lastname: Cain
authors.forename: Anoop
authors.initials: A
authors.lastname: Shankar
authors.forename: Alan M
authors.initials: AM
authors.lastname: Ducatman
authors.forename: Kyle
authors.initials: K
authors.lastname: Steenland
mesh_terms: D000328:Adult; D001061:Appalachian Region; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology; D002908:Chronic Disease; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid