title: Elevated Serum Uric Acid Level Predicts Rapid Decline in Kidney Function.
abstract: BACKGROUND
  While elevated serum uric acid level (SUA) is a recognized risk factor for chronic kidney disease, it remains unclear whether change in SUA is independently associated with change in estimated glomerular filtration rate (eGFR) over time. Accordingly, we examined the longitudinal associations between change in SUA and change in eGFR over 5 years in a general Japanese population.
  
  
  METHODS
  This was a large, single-center, retrospective 5-year cohort study at St. Luke's International Hospital, Tokyo, Japan, between 2004 and 2009. We included 13,070 subjects (30-85 years) in our analyses whose data were available between 2004 and 2009. Of those, we excluded 492 subjects with eGFR <60 mL/min/1.73 m2 at baseline. In addition to examining the entire cohort (n = 12,578), we stratified our analyses by baseline eGFR groups: 60-90, 90-120, and ≥120 mL/min/1.73 m2. Linear and logistic regressions models were applied to examine the relationships between baseline and change in SUA, change in eGFR, and rapid eGFR decline (defined as the highest quartile of change in eGFR), adjusted for age, gender, body mass index, abdominal circumference, hypertension, dyslipidemia, and diabetes mellitus.
  
  
  RESULTS
  After multivariable adjustments including baseline eGFR, 1 mg/dL increase in baseline SUA was associated with greater odds of developing rapid eGFR decline (OR 1.27, 95% CI 1.17-1.38), and 1 mg/dL increase in SUA over 5 years was associated with 3.77-fold greater odds of rapid eGFR decline (OR 3.77, 95% CI 3.35-4.26).
  
  
  CONCLUSIONS
  Elevated baseline SUA and increasing SUA over time were independent risk factors for rapid eGFR decline over 5 years.
authors.affiliation: School of Medicine, Division of Renal Diseases and Hypertension, University of Colorado, Denver, CO, USA.
authors.forename: Masanari
authors.initials: M
authors.lastname: Kuwabara
authors.forename: Petter
authors.initials: P
authors.lastname: Bjornstad
authors.forename: Ichiro
authors.initials: I
authors.lastname: Hisatome
authors.forename: Koichiro
authors.initials: K
authors.lastname: Niwa
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Roncal-Jimenez
authors.forename: Ana
authors.initials: A
authors.lastname: Andres-Hernando
authors.forename: Thomas
authors.initials: T
authors.lastname: Jensen
authors.forename: Tamara
authors.initials: T
authors.lastname: Milagres
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sato
authors.forename: Gabriela
authors.initials: G
authors.lastname: Garcia
authors.forename: Minoru
authors.initials: M
authors.lastname: Ohno
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Lanaspa
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid