Relationship between Serum Uric Acid Levels and Chronic Kidney Disease in a Japanese Cohort with Normal or Mildly Reduced Kidney Function.
Relationship between Serum Uric Acid Levels and Chronic Kidney Disease in a Japanese Cohort with Normal or Mildly Reduced Kidney Function.
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DOI：
10.1371/journal.pone.0137449
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Wada T
中科院分区：
文献类型：
--
作者：
Toyama T;Furuichi K;Shimizu M;Hara A;Iwata Y;Sakai N;Perkovic V;Kobayashi M;Mano T;Kaneko S;Wada T
一些观察性研究显示了高尿酸血症与慢性肾脏病（CKD）之间的关系;然而，肾功能恶化的血尿酸（SUA）阈值以及SUA与基线肾功能肾损伤之间的相关性仍不清楚。本研究旨在阐明SUA与肾功能下降之间的关系。我们分析了1998年至2007年期间接受医疗检查的日本男性个体的历史队列。纳入具有基线数据且随访至少一年的参与者，并根据基线肾功能进行分层。肾功能分类为正常[估计肾小球滤过率（eGFR）≥ 90 ml/min/1.73 m2]或轻度降低（eGFR 60-89 ml/min/1.73 m2）。测量的结果是肾损害，定义为eGFR降低至< 60 ml/min/1.73 m2。评估了SUA与结局风险和eGFR斜率之间的相关性。共纳入41632例受试者，平均年龄45.4岁。在平均4年的随访中，3186例（7.6%）受试者发生肾功能不全。与SUA为4-4.9 mg/dL的受试者相比，SUA ≥ 6.0 mg/dL的受试者发生肾损害的风险显著增加。根据基线肾功能，SUA阈值水平不同;肾功能正常和轻度降低的SUA分别≥ 7.0和≥ 6.0 mg/dL。eGFR斜率观察到大致相同的趋势。在一般人群中，高尿酸血症似乎是男性肾损害的危险因素。对于轻度肾功能不全的参与者，即使SUA轻微升高也可能是一个风险因素。
Some observational studies have shown the relationships between hyperuricemia and chronic kidney disease (CKD); however, the threshold of serum uric acid (SUA) for deterioration of kidney function and the association between SUA and kidney injury by baseline kidney function remains unclear. This study aimed to clarify the relationships between SUA and reduced kidney function. We analyzed a historical cohort of male Japanese individuals who underwent medical checkup between 1998 and 2007. Participants with baseline data and who were followed up for at least one year were included and stratified according to baseline kidney function. Kidney function was classified as normal [estimated glomerular filtration rate (eGFR) ≥ 90 ml/min/1.73 m2] or mildly reduced (eGFR 60–89 ml/min/1.73 m2). The outcome measured was kidney impairment defined as a decrease in eGFR to < 60 ml/min/1.73 m2. Associations between SUA and risk for outcome and eGFR slopes were assessed. A total of 41632 subjects with mean age 45.4 years were included. During a mean follow-up of four years, 3186 (7.6%) subjects developed kidney dysfunction. Subjects with SUA ≥ 6.0 mg/dL had a significantly increased risk for kidney impairment compared with subjects with SUA of 4–4.9 mg/dL. SUA threshold levels were different according to baseline kidney function; SUA ≥ 7.0 and ≥ 6.0 mg/dL for normal and mildly reduced kidney function, respectively. Approximately the same trends were observed for eGFR slopes. In the general population, hyperuricemia appears to be a risk factor for kidney impairment in males. For participants with mild kidney dysfunction, even a slight elevation of SUA can be a risk factor.