Uric acid and incident kidney disease in the community
Uric acid and incident kidney disease in the community
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DOI：
10.1681/asn.2007101075
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发表时间：
2008-06-01
影响因子：
13.6
通讯作者：
Levey, Andrew S.
中科院分区：
文献类型：
--
作者：
Weiner, Daniel E.;Tighiouart, Hocine;Levey, Andrew S.
尿酸可能通过肾血管收缩和全身性高血压介导高血压和肾脏疾病之间的关系。为了研究尿酸与随后肾功能下降之间的关系，将两个社区队列中13，338名肾功能完整的参与者的有限访问数据汇总，社区动脉粥样硬化风险和心血管健康研究。平均基线血清尿酸为5.9 +/-1.5 mg/dl，平均基线血清肌酐为0.9 +/-0.2 mg/dl，平均基线估计GFR为90.4 +/-19.4 ml/min/1.73 m（2）。在8.5 ± 0.9年的随访中，712例（5.6%）发生了肾小球滤过率下降（≥ 15 ml/min/1.73 m2，最终肾小球滤过率= 0.4 mg/dl，男性最终血清肌酐> 1.4 mg/dl，女性> 1.2 mg/dl）的肾脏疾病。在基于GFR和肌酐的逻辑回归模型中，基线尿酸水平与肾脏疾病发病风险增加相关（尿酸每增加1 mg/dl，比值比分别为1.07 [95%置信区间1.01 - 1.14]和1.11 [95%置信区间1.02 - 1.21]），校正年龄、性别、种族、糖尿病、收缩压、高血压、心血管疾病、左心室肥大、吸烟、饮酒、教育、血脂、白蛋白、红细胞压积、基线肾功能和队列;因此，血清尿酸水平升高是一般人群中肾脏疾病事件的适度独立风险因素。
Uric acid may mediate aspects of the relationship between hypertension and kidney disease via renal vasoconstriction and systemic hypertension. To investigate the relationship between uric acid and subsequent reduced kidney function, limited-access data of 13,338 participants with intact kidney function in two community-based cohorts, the Atherosclerosis Risks in Communities and the Cardiovascular Health Study, were pooled. Mean baseline serum uric acid was 5.9 +/- 1.5 mg/dl, mean baseline serum creatinine was 0.9 +/- 0.2 mg/dl, and mean baseline estimated GFR was 90.4 +/- 19.4 ml/min/1.73 m(2). During 8.5 +/- 0.9 yr of follow-up, 712 (5.6%) had incident kidney disease defined by GFR decrease ( >= 15 ml/min/1.73 m(2) with final GFR = 0.4 mg/dl with final serum creatinine >1.4 mg/dl in men and 1.2 mg/dl in women). In GFR- and creatinine-based logistic regression models, baseline uric acid level was associated with increased risk for incident kidney disease (odds ratio 1.07 [95% confidence interval 1.01 to 1.14] and 1.11 [95% confidence interval 1.02 to 1.21] per 1-mg/dl increase in uric acid, respectively), after adjustment for age, gender, race, diabetes, systolic BP, hypertension, cardiovascular disease, left ventricular hypertrophy, smoking, alcohol use, education, lipids, albumin, hematocrit, baseline kidney function and cohort; therefore, elevated serum uric acid level is a modest, independent risk factor for incident kidney disease in the general population.