title: The impact of elevation of serum uric acid level on the natural history of glomerular filtration rate (GFR) and its sex difference.
abstract: BACKGROUND
  The impact of elevation of the serum uric acid level (SUA) on the natural history of glomerular filtration rate (GFR) remains controversial.
  
  
  METHODS
  If elevation of SUA is a result, rather than a cause, of a decline in GFR, the relationship between SUA and GFR should be the same in the same population over years except for shifts by age-dependent reduction of GFR. We tested this hypothesis using data from two cohorts and a group of allopurinol-treated patients.
  
  
  RESULTS
  In Cohort 1 consisting of urban residents aged 40.6 ± 9.0 years (n = 3 446), SUA was inversely correlated with estimated GFR (eGFR) in both men and women, and the slope of the SUA-eGFR relationship was steeper in women than in men. The slopes of the regression lines became significantly steeper after a 6-year interval in both sexes, and the change in the slope was larger in women. A similar sex difference in the SUA-eGFR relationship and 6-year change in the slope were observed in Cohort 2 consisting of rural town residents aged 61.7 ± 12.2 years (n = 404). Multiple regression analyses showed that explanatory factors of eGFR after a 6-year interval were age and SUA at baseline in both cohorts, and partial regression coefficients of SUA were more negative in women than in men. The SUA-eGFR relationship in allopurinol-treated patients (n = 346, 63.5 ± 13.3 years old) was similar to that in Cohort 2.
  
  
  CONCLUSIONS
  The results indicate that elevation of SUA accelerates the yearly decline in eGFR and that women are more susceptible to urate-induced decline in eGFR.
authors.affiliation: Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University, Sapporo 060-8543, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Akasaka
authors.affiliation: Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University, Sapporo 060-8543, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yoshida
authors.affiliation: Department of Nephrology, Tenine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Takizawa
authors.affiliation: Keijinkai Maruyama Clinic, Sapporo, Japan.
authors.forename: Nagisa
authors.initials: N
authors.lastname: Hanawa
authors.affiliation: Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University, Sapporo 060-8543, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Tobisawa
authors.affiliation: Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University, Sapporo 060-8543, Japan.
authors.forename: Marenao
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Nephrology, Tenine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Norihito
authors.initials: N
authors.lastname: Moniwa
authors.affiliation: Department of Nephrology, JR Sapporo Hospital, Sapporo, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Togashi
authors.affiliation: Department of Nephrology, JR Sapporo Hospital, Sapporo, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Yamashita
authors.affiliation: Department of Medicine, Gorinbashi Hospital, Sapporo, Japan.
authors.forename: Setsuko
authors.initials: S
authors.lastname: Kuroda
authors.affiliation: Department of General Medicine, Tenine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ura
authors.affiliation: Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University, Sapporo 060-8543, Japan.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Miura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000627:therapeutic use; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use; D005919:Glomerular Filtration Rate; D006801:Humans; D033461:Hyperuricemia / Q000097:blood* / Q000188:drug therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012424:Rural Population; D012737:Sex Factors; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
chemical_list: D016166:Free Radical Scavengers; D014527:Uric Acid; D000493:Allopurinol
keywords: epidemiology; glomerular filtration rate; hyperuricemia; sex difference