title: A slight increase within the normal range of serum uric acid and the decline in renal function: associations in a community-based population.
abstract: BACKGROUND
  Hyperuricemia is a risk factor for adverse renal outcomes in patients with chronic kidney disease. This study investigated the effect of uric acid on renal function in a community-based population.
  
  
  METHODS
  We used a nationwide database of 165 847 subjects (aged 29-74, male 40%) who participated in the annual 'Specific Health Check and Guidance in Japan' checkup between 2008 and 2010; we examined the relationship between serum uric acid levels at baseline and 2-year change in the estimated glomerular filtration rate (eGFR) obtained by using the Japanese equation.
  
  
  RESULTS
  After adjusting for possible confounders, the eGFR change was inversely correlated with uric acid at baseline. In the multivariable analysis, the decline in eGFR was significantly more rapid in subjects with the slight increase in uric acid (males ≥5.7 mg/dL, females ≥4.4 mg/dL), and the risk for incidental renal insufficiency (eGFR <60 mL/min/1.73 m(2)) was increased at uric acid of ≥6.3 mg/dL in males and ≥5.5 mg/dL in females, compared with the lowest quintile. The multiple linear regression analysis revealed that the effect of uric acid on eGFR changes was significant, especially in females, those with proteinuria and diabetes and those without alcohol consumption.
  
  
  CONCLUSIONS
  This study showed that serum uric acid is independently associated with a more rapid decline of eGFR and incident renal insufficiency, and that a slight increase within the normal range of serum uric acid might be a risk for renal damage in the general population.
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Keita
authors: K
authors: Kamei
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup, The Ministry of Health, Labour and Welfare of Japan, Fukushima, Japan.
authors: Tsuneo
authors: T
authors: Konta
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Atsushi
authors: A
authors: Hirayama
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Kazuko
authors: K
authors: Suzuki
authors: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors: Kazunobu
authors: K
authors: Ichikawa
authors: Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup, The Ministry of Health, Labour and Welfare of Japan, Fukushima, Japan.
authors: Shouichi
authors: S
authors: Fujimoto
authors: Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup, The Ministry of Health, Labour and Welfare of Japan, Fukushima, Japan.
authors: Kunitoshi
authors: K
authors: Iseki
authors: Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup, The Ministry of Health, Labour and Welfare of Japan, Fukushima, Japan.
authors: Toshiki
authors: T
authors: Moriyama
authors: Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup, The Ministry of Health, Labour and Welfare of Japan, Fukushima, Japan.
authors: Kunihiro
authors: K
authors: Yamagata
authors: Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup, The Ministry of Health, Labour and Welfare of Japan, Fukushima, Japan.
authors: Kazuhiko
authors: K
authors: Tsuruya
authors: Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup, The Ministry of Health, Labour and Welfare of Japan, Fukushima, Japan.
authors: Kenjiro
authors: K
authors: Kimura
authors: Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup, The Ministry of Health, Labour and Welfare of Japan, Fukushima, Japan.
authors: Ichiei
authors: I
authors: Narita
authors: Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup, The Ministry of Health, Labour and Welfare of Japan, Fukushima, Japan.
authors: Masahide
authors: M
authors: Kondo
authors: Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup, The Ministry of Health, Labour and Welfare of Japan, Fukushima, Japan.
authors: Koichi
authors: K
authors: Asahi
authors: Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup, The Ministry of Health, Labour and Welfare of Japan, Fukushima, Japan.
authors: Tsuyoshi
authors: T
authors: Watanabe
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D033461:Hyperuricemia / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012016:Reference Values; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid
keywords: cohort study; renal function; uric acid