Association between serum uric acid and new onset and progression of chronic kidney disease in a Japanese general population: Iki epidemiological study of atherosclerosis and chronic kidney disease
Association between serum uric acid and new onset and progression of chronic kidney disease in a Japanese general population: Iki epidemiological study of atherosclerosis and chronic kidney disease
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DOI：
10.1007/s10157-021-02042-7
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发表时间：
2021-03-10
影响因子：
2.3
通讯作者：
Nakashima, Hitoshi
中科院分区：
文献类型：
--
作者：
Tada, Kazuhiro;Maeda, Toshiki;Nakashima, Hitoshi
背景：尽管慢性肾脏病(CKD)的危险因素已被提出，但血清尿酸(SUA)升高是否与肾功能呈负相关仍不清楚。这项研究的目的是阐明血尿酸与日本普通人群中CKD的新发病和进展之间的关系。方法采用Iki岛居民年度健康体检资料，进行以人群为基础的回顾性队列研究。共有5,507名成年人(979名CKD患者和4,528名非CKD患者)纳入研究。结果是基线时没有CKD的参与者新发CKD，有CKD的参与者CKD进展。使用COX比例风险模型来评估血尿酸与CKD新发和进展之间的关联。结果平均随访4.6年，新发CKD 757例，进展CKD 193例。尿酸与CKD的新发病显著相关(调整后的危险比为1.13，每标准差[SD]增加的可信区间为1.03-1.24])。相比之下，血尿酸与慢性肾脏病的进展没有显著关联(危险比1.08，每增加一次SD[0.92-1.27])。当将尿酸归类为类别时，也得到了类似的结果。结论在日本普通人群中，尿酸与新发CKD的风险增加显著相关，但与CKD的进展无关。
Background Although several risk factors for chronic kidney disease (CKD) have been proposed, it remains unclear whether elevated serum uric acid (SUA) is negatively association with kidney function. The aim of this study was to elucidate the association between SUA and new onset and progression of CKD in a Japanese general population. Methods This was a population-based retrospective cohort study using annual health checkup data of residents of Iki Island. A total of 5,507 adults (979 with CKD and 4,528 without) were included. The outcomes were new onset of CKD among participants without CKD at baseline, and progression of CKD among those with CKD. A Cox proportional hazards model was used to evaluate the association between SUA and new onset and progression of CKD. Results During mean follow-up of 4.6 years, 757 cases of new onset of CKD and 193 with progression of CKD were observed. SUA was significantly associated with new onset of CKD (adjusted hazard ratio 1.13, [95% confidence interval 1.03-1.24] per standard deviation [SD] increase in SUA). In contrast, SUA was not significantly associated with progression of CKD (hazard ratio 1.08, [0.92-1.27] per SD increase). Similar results were obtained when classifying uric acid as categorical. Conclusion SUA was significantly associated with increased risk for new onset of CKD, but not with progression of CKD among a Japanese general population.