title: Serum uric acid and chronic kidney disease: the role of hypertension.
abstract: BACKGROUND
  There are inconsistent findings on the role of hyperuricemia as an independent risk factor for chronic kidney disease (CKD). Hypertension has been implicated as a factor influencing the association between serum uric acid and CKD. In this population-based study we investigated the association between serum uric acid and decline in renal function and tested whether hypertension moderates this association.
  
  
  METHODS
  We included 2601 subjects aged 55 years and over from the Rotterdam Study. Serum uric acid and estimated glomerular filtration rate (eGFR) were assessed at baseline. After average 6.5 years of follow-up, second eGFR was assessed. CKD was defined as eGFR<60 ml/min/1.73 m(2). All associations were corrected for socio-demographic and cardiovascular factors.
  
  
  RESULTS
  Each unit (mg/dL) increase in serum uric acid was associated with 0.19 ml/min per 1.73 m(2) faster annual decline in eGFR. While the association between serum uric acid and incidence of CKD was not significant in our study population (Hazard Ratio: 1.12, 95% confidence interval [CI]: 0.98-1.28), incorporating our results in a meta-analysis with eleven published studies revealed a significant association (Relative Risk: 1.18, 95%CI: 1.15-1.22). In the stratified analyses, we observed that the associations of serum uric acid with eGFR decline and incident CKD were stronger in hypertensive subjects (P for interaction = 0.046 and 0.024, respectively).
  
  
  CONCLUSIONS
  Our findings suggest that hyperuricemia is independently associated with a decline in renal function. Stronger association in hypertensive individuals may indicate that hypertension mediates the association between serum uric acid and CKD.
authors.affiliation: Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Sanaz
authors.initials: S
authors.lastname: Sedaghat
authors.forename: Ewout J
authors.initials: EJ
authors.lastname: Hoorn
authors.forename: Frank J A
authors.initials: FJ
authors.lastname: van Rooij
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
authors.forename: Abbas
authors.initials: A
authors.lastname: Dehghan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000209:etiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid