title: Hyperuricemia and deterioration of renal function in autosomal dominant polycystic kidney disease.
abstract: BACKGROUND
  The role of hyperuricemia in disease progression of autosomal dominant polycystic kidney disease (ADPKD) has not been defined well. We investigated the association of serum uric acid (sUA) with renal function and the effect of hypouricemic treatment on the rate of renal function decline.
  
  
  METHODS
  This is a single-center, retrospective, observational cohort study. A total of 365 patients with ADPKD who had estimated glomerular filtration rate (eGFR) ≥ 15 mL/min/1.73 m2 and who were followed up for > 1 year were included in our analysis. Hyperuricemia was defined by a sUA level of ≥ 7.0 mg/dL in male and ≥ 6.0 mg/dL in female or when hypouricemic medications were prescribed.
  
  
  RESULTS
  Hyperuricemia was associated with reduced initial eGFR, independent of age, sex, hypertension, albuminuria, and total kidney volume. During a median follow-up period of over 6 years, patients with hyperuricemia showed a faster annual decline in eGFR (-6.3% per year vs. -0.9% per year, p = 0.008). However, after adjusting for age, sex, hypertension and initial eGFR, sUA was no longer associated with either annual eGFR decline or the development of ESRD. Among 53 patients who received hypouricemic treatment, the annual eGFR decline appeared to be attenuated after hypouricemic treatment (pretreatment vs. posttreatment: -5.3 ± 8. 2 vs. 0.2 ± 6.2 mL/min/1.73 m2 per year, p = 0.001 by Wilcoxon signed-rank test).
  
  
  CONCLUSIONS
  Although hyperuricemia was associated with reduced eGFR, it was not an independent factor for renal progression in ADPKD. However, the correction of hyperuricemia may attenuate renal function decline in some patients with mild renal insufficiency.
authors.forename: Miyeun
authors.initials: M
authors.lastname: Han
authors.forename: Hayne Cho
authors.initials: HC
authors.lastname: Park
authors.forename: Hyunsuk
authors.initials: H
authors.lastname: Kim
authors.forename: Hyung Ah
authors.initials: HA
authors.lastname: Jo
authors.forename: Hyuk
authors.initials: H
authors.lastname: Huh
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Ah-Young
authors.initials: AY
authors.lastname: Kang
authors.forename: Seung Hyup
authors.initials: SH
authors.lastname: Kim
authors.forename: Hae Il
authors.initials: HI
authors.lastname: Cheong
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Kang
authors.forename: Jaeseok
authors.initials: J
authors.lastname: Yang
authors.forename: Kook-Hwan
authors.initials: KH
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. ondahl@eulji.ac.kr.
authors.forename: Young-Hwan
authors.initials: YH
authors.lastname: Hwang
authors.forename: Curie
authors.initials: C
authors.lastname: Ahn
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D033461:Hyperuricemia / Q000175:diagnosis* / Q000401:mortality*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000175:diagnosis* / Q000401:mortality*; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000401:mortality*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D055815:Young Adult
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