title: Hyperuricaemia and accelerated reduction in renal function.
abstract: OBJECTIVE
  Hyperuricaemia has been linked to reduced renal function, and evidence indicates that it may be associated with acceleration of the decline in glomerular filtration rate (GFR) and progression of chronic kidney disease (CKD).
  
  
  METHODS
  We analysed a population of subjects who had undergone serum uric acid (SUA) and serum creatinine measurements in a hospital-based cohort. Initial and final serum creatinine measurements were used to calculate the estimated glomerular filtration rate (eGFR) and the annual decline in eGFR. Cox regression was used to investigate the relationship between SUA and CKD progression.
  
  
  RESULTS
  A total of 63,785 subjects were enrolled in the study during a 12-year follow-up period. The mean age at the time of initial serum creatinine measurement was 50.0 ± 14.9 years. Hyperuricaemic subjects had a significantly larger annual eGFR decline, both in absolute terms (2.5 ± 9.5 mL/min/1.73 m(2) per year) and as a percentage (2.8 ± 11.6% per year), as compared to the normouricaemia group (1.3 ± 9.6 mL/min/1.73 m(2) per year, 1.1 ± 11.1% per year, p < 0.001). After adjustment for age, sex, status of diabetes mellitus (DM) and hypertension, baseline eGFR, azotaemia, hypercholesterolaemia, and hyperglycaemia, hyperuricaemia was associated with a hazard ratio (HR) of 1.28 [95% confidence interval (CI) 1.23-1.33, p < 0.001] for an accelerated eGFR decline ≥ 3 mL/min/1.73 m(2) per year and an HR of 1.52 (95% CI 1.46-1.59) for CKD progression at the end of follow-up.
  
  
  CONCLUSIONS
  Hyperuricaemia was associated with an accelerated decline in eGFR and higher risk of CKD progression. Therefore, renal function should be monitored closely in patients with hyperuricaemia.
authors.affiliation: Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.
authors.forename: C-F
authors.initials: CF
authors.lastname: Kuo
authors.forename: S-F
authors.initials: SF
authors.lastname: Luo
authors.forename: L-C
authors.initials: LC
authors.lastname: See
authors.forename: Y-S
authors.initials: YS
authors.lastname: Ko
authors.forename: Y-M
authors.initials: YM
authors.lastname: Chen
authors.forename: J-S
authors.initials: JS
authors.lastname: Hwang
authors.forename: I-J
authors.initials: IJ
authors.lastname: Chou
authors.forename: H-C
authors.initials: HC
authors.lastname: Chang
authors.forename: H-W
authors.initials: HW
authors.lastname: Chen
authors.forename: K-H
authors.initials: KH
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000209:etiology; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology; D033461:Hyperuricemia / Q000097:blood / Q000150:complications*; D007674:Kidney Diseases / Q000209:etiology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D014527:Uric Acid / Q000097:blood
chemical_list: D014527:Uric Acid; D003404:Creatinine