title: Serum Uric Acid Level Predicts Progression of IgA Nephropathy in Females but Not in Males.
abstract: BACKGROUND
  Immunoglobulin A nephropathy (IgAN) is one of most common forms of glomerulonephritis. At this point, the clinical impact of hyperuricemia on IgAN is not clear. The aim of the present study was to explore the clinical impact of hyperuricemia on the progression of IgAN.
  
  
  METHODS
  Multicenter retrospective cohort study.
  
  
  METHODS
  935 IgAN patients who were diagnosed by kidney biopsy at Osaka University Hospital, Osaka General Hospital, and Osaka Rosai Hospital. were included in this study.
  
  
  METHODS
  Uric acid levels at renal biopsy.
  
  
  RESULTS
  The outcome of interest was the time from the kidney biopsy to the time when a 50% increase in the baseline serum creatinine level was observed, which was defined as "progression".
  
  
  METHODS
  The baseline characteristics according to the kidney biopsy at the time of diagnosis were collected from the medical records, and included age, gender, body mass index, hypertension, diabetes (use of antidiabetic drugs), serum levels of creatinine, urinary protein, smoking status, RAAS blockers and steroid therapy.
  
  
  RESULTS
  An elevated serum uric acid level was an independent risk factor for progression in female patients (per 1.0 mg/dL, multivariate-adjusted incident rate ratio 1.33 [95% confidence interval 1.07, 1.64], P = 0.008) but not in male patients (1.02 [0.81, 1.29], P = 0.855). To control a confounding effect of renal function on an association between serum uric acid level and progression in female patients, age- and serum creatinine-matched and propensity score-matched analyses were performed, and these results also supported the effect by uric acid on kidney disease progression independent of basal kidney function.
  
  
  CONCLUSIONS
  A cohort analyzed retorospectively.
  
  
  CONCLUSIONS
  This study revealed that an elevated uric acid level was an independent risk factor for ESKD in female IgAN patients. Therefore, uric acid might be a treatable target in female IgAN patients.
authors: Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine 1-1 Mukogawa-Cho, Nishinomiya, Hyogo, Japan.
authors: Yasuyuki
authors: Y
authors: Nagasawa
authors: Health Care Center, Osaka University, Toyonaka, Osaka, Japan.
authors: Ryohei
authors: R
authors: Yamamoto
authors: Department of Kidney Disease and Hypertension, Osaka General Medical Center, Osaka, Osaka, Japan.
authors: Tatsuya
authors: T
authors: Shoji
authors: Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors: Maki
authors: M
authors: Shinzawa
authors: Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine 1-1 Mukogawa-Cho, Nishinomiya, Hyogo, Japan.
authors: Yukiko
authors: Y
authors: Hasuike
authors: Division of Nephrology, Department of Internal Medicine, Osaka Rosai Hospital, Sakai, Osaka, Japan.
authors: Katsuyuki
authors: K
authors: Nagatoya
authors: Division of Nephrology, Department of Internal Medicine, Osaka Rosai Hospital, Sakai, Osaka, Japan.
authors: Atsushi
authors: A
authors: Yamauchi
authors: Department of Kidney Disease and Hypertension, Osaka General Medical Center, Osaka, Osaka, Japan.
authors: Terumasa
authors: T
authors: Hayashi
authors: Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine 1-1 Mukogawa-Cho, Nishinomiya, Hyogo, Japan.
authors: Takayuki
authors: T
authors: Kuragano
authors: Health Care Center, Osaka University, Toyonaka, Osaka, Japan.
authors: Toshiki
authors: T
authors: Moriyama
authors: Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors: Yoshitaka
authors: Y
authors: Isaka
authors: Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine 1-1 Mukogawa-Cho, Nishinomiya, Hyogo, Japan.
authors: Takeshi
authors: T
authors: Nakanishi
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D005922:Glomerulonephritis, IGA / Q000097:blood* / Q000175:diagnosis*; D006801:Humans; D033461:Hyperuricemia / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
chemical_list: D014527:Uric Acid