title: Uric acid and incident chronic kidney disease in a large health check-up population in Taiwan.
abstract: OBJECTIVE
  Uric acid (UA) is strongly associated with the confirmed chronic kidney disease (CKD) risk factors, such as hypertension, diabetes and metabolic syndrome (MS); however, whether higher UA is independently associated with CKD is still debatable. Other studies found that low UA level may reflect inadequate protection against oxidant-mediated stress; it is also unknown whether hypouricemia may have a harmful effect on the kidney. No studies have examined whether there is a J-shaped relationship between UA and incident CKD.
  
  
  METHODS
  The association between UA and incident kidney disease (Glomerular filtration rate <60 mL/min per 1.73 m(2) ) was examined among 94 422 Taiwanese participants, aged ≥20 years with a mean 3.5 years follow-up in a retrospective cohort. The association between UA and CKD was evaluated using Cox models with adjustment for confounders.
  
  
  RESULTS
  The adjusted hazard ratio (HR) for incident CKD was 1.03 (95% confidence interval (CI), 1.01 to 1.06) for baseline UA level (increase by 1 mg/dL). Compared with serum UA in the first quintile (2.0 to 4.5 mg/dL), the multivariate-adjusted HR for CKD of the fifth (≥7.3 mg/dL), fourth (6.3 to 7.2 mg/dL), third (5.5 to 6.2 mg/dL), second (4.6 to 5.4 mg/dL) and hyopuricemia (<2.0 mg/dL) were 1.15 (95%CI, 1.01-1.30), 0.98 (95%CI, 0.87-1.10), 1.06 (95%CI, 0.94-1.19), 1.02 (95%CI, 0.91-1.14) and 1.65(95%CI, 0.53-5.15), respectively. The tests for the non-linear association were all not significant for both male and female. Gender-specific model revealed only the UA above 7.3 mg/dL with the increased risk of new-onset CKD in males.
  
  
  CONCLUSIONS
  Hyperuricemia is a risk factor for CKD in Taiwan, future studies are still necessary to determine whether hypouricemia increases the risk of CKD.
authors.affiliation: Department of Epidemiology and Bio-statistics, School of Public Health, Peking University Health Science Center, Beijing, China.
authors.forename: Shengfeng
authors.initials: S
authors.lastname: Wang
authors.forename: Zheng
authors.initials: Z
authors.lastname: Shu
authors.forename: Qiushan
authors.initials: Q
authors.lastname: Tao
authors.forename: Canqing
authors.initials: C
authors.lastname: Yu
authors.forename: Siyan
authors.initials: S
authors.lastname: Zhan
authors.forename: Liming
authors.initials: L
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D033461:Hyperuricemia / Q000097:blood* / Q000453:epidemiology*; D015994:Incidence; D016015:Logistic Models; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
chemical_list: D014527:Uric Acid