title: An association between uric acid levels and renal arteriolopathy in chronic kidney disease: a biopsy-based study.
abstract: Uric acid (UA) can induce renal arteriolopathy in animal models. Whether there is an association between UA and renal arteriolopathy in patients with chronic kidney disease (CKD) is unknown. Here, we examined the cross-sectional association of serum UA levels with renal arteriolar hyalinosis and wall thickening. Arteriolar parameters were assessed by semiquantitative grading (max: grade 3) of arterioles in 167 patients with CKD (mean age, 42.4 years; 86 men and 81 women) who underwent renal biopsy. The mean serum UA level was 6.4 mg dl(-1). We observed hyalinosis in 94 patients (56%) and wall thickening in 119 patients (71%). As the UA level tertile increased, the proportion of higher-grade (grade 2 and 3) hyalinosis and wall thickening increased (hyalinosis, P<0.0001 and wall thickening, P=0.0002, for trend). Multiple logistic analysis adjusted for age ≥40 years, sex, hypertension status, diabetes mellitus status and estimated glomerular filtration rate <60 ml min(-1) per 1.73 m(2) showed that hyperuricemia (UA ≥7 mg dl(-1)) was significantly associated with a higher risk of hyalinosis (adjusted odds ratio: 3.13; 95% confidence interval: 1.23-7.94; P=0.02) and higher-grade (equal to or higher than the mean value) wall thickening (adjusted odds ratio: 2.66; 95% confidence interval: 1.11-6.38; P=0.03). Hence, these results suggest that hyperuricemia may be related to renal arteriolar damage in patients with CKD.
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Okinawa, Japan. kohagura@med.u-ryukyu.ac.jp
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kohagura
authors.forename: Masako
authors.initials: M
authors.lastname: Kochi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Miyagi
authors.forename: Takanori
authors.initials: T
authors.lastname: Kinjyo
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Maehara
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Nagahama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sakima
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Iseki
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ohya
mesh_terms: D000328:Adult; D001160:Arterioles / Q000473:pathology; D001706:Biopsy; D003430:Cross-Sectional Studies; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D033461:Hyperuricemia / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012078:Renal Artery Obstruction / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D012079:Renal Circulation / Q000502:physiology; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
chemical_list: D014527:Uric Acid