title: Hyperuricemia as a Predictive Marker for Progression of Nephrosclerosis: Clinical Assessment of Prognostic Factors in Biopsy-Proven Arterial/Arteriolar Nephrosclerosis.
abstract: OBJECTIVE
  The influence of serum urate on kidney disease is attracting attention, but the effects of uric acid (UA) on nephrosclerosis have not been elucidated.
  
  
  METHODS
  We reviewed data from 45 patients diagnosed with arterial/arteriolar nephrosclerosis. The renal outcomes of the arterial/arteriolar nephrosclerosis patients were assessed by performing logistic and Cox regression analyses. A Kaplan-Meier analysis was used to evaluate the impact of hyperuricemia (HU) on kidney survival. The renal outcomes of patients with and without HU were compared by using a propensity score-matched cohort.
  
  
  RESULTS
  The logistic regression models showed no significant differences in renal outcomes, according to baseline parameters or follow-up parameters, except the serum UA value and body mass index (BMI). Baseline serum UA level had the highest odds ratio (OR) for estimated glomerular filtration rate (eGFR) decline (OR, 1.86; 95% confidence interval (CI), 1.12 to 3.45), among the parameters assessed. In the multivariate Cox regression analysis, HU (UA ≥8.0 mg/dL) (P=0.01) and BMI (P=0.03) were significantly associated with a ≥50% eGFR decline or ESRD. The Kaplan-Meier analysis in the propensity score-matched cohort indicated that the renal survival rate of the group of arterial/arteriolar nephrosclerosis patients with HU was significantly lower than that of the group without HU (log rank, P=0.03).
  
  
  CONCLUSIONS
  The results of this study suggest that the baseline serum UA value can serve as a renal outcome predictor in arterial/arteriolar nephrosclerosis patients.
authors: Department of Medicine, Kidney Center, Tokyo Women's Medical University.
authors: Kumiko
authors: K
authors: Momoki
authors: Department of Medicine, Kidney Center, Tokyo Women's Medical University.|Clinical Research Division for Polycystic Kidney Disease, Department of Medicine, Kidney Center, Tokyo Women's Medical University.
authors: Hiroshi
authors: H
authors: Kataoka
authors: Department of Medicine, Kidney Center, Tokyo Women's Medical University.
authors: Takahito
authors: T
authors: Moriyama
authors: Department of Medicine, Kidney Center, Tokyo Women's Medical University.|Clinical Research Division for Polycystic Kidney Disease, Department of Medicine, Kidney Center, Tokyo Women's Medical University.
authors: Toshio
authors: T
authors: Mochizuki
authors: Department of Medicine, Kidney Center, Tokyo Women's Medical University.
authors: Kosaku
authors: K
authors: Nitta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D015331:Cohort Studies; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000378:metabolism; D033461:Hyperuricemia / Q000097:blood / Q000175:diagnosis*; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000175:diagnosis / Q000378:metabolism; D009400:Nephrosclerosis / Q000097:blood / Q000175:diagnosis*; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000097:blood; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014527:Uric Acid
keywords: Arterial/arteriolar sclerosis; Biopsy; Hyperuricemia; Prognosis; nephrosclerosis