P0778INVESTIGATION THE EFFECT OF SERUM URIC ACID ON NEW-ONSET AND PROGRESSION OF CHRONIC KIDNEY DISEASE(CKD) IN JAPANESE GENERAL POPULATION : IKI EPIDEMIOLOGICAL STUDY OF ARTHEROSCLEROSIS AND CHRONIC KIDNEY DISEASE(ISSA-CKD) RETROSPECTIVE PHASE

Abstract Background and Aims Chronic kidney disease is one of the most urgent public health issue in Japan as well as other countries. Many risk factors for development and progression of CKD have been recognized, such as hypertension, diabetes, obesity. However, it is still unclear whether increase of serum uric acid has negative impact on kidney function. The aim of this study is to investigate how serum uric acid influences the new-onset and progression of CKD in Japanese general population. Method The Iki epidemiological Study of atherosclerosis And Chronic Kidney Disease (ISSA-CKD) is a population-based retrospective cohort study using annual health check-up data in the Iki Island (Nagasaki Prefecture, Japan), which has approximately 27,000 residents. A total of 7,645 residents underwent annual health check-ups from fiscal year 2008 to 2016. After excluding residents who visited only 1 health check-up and those with missing information of serum creatinine or serum uric acid, a total of 5507 adults were included in the present analysis. The outcome of the present analysis was new-onset of CKD (reduction in estimated glomerular filtration rate [eGFR] less than 60mL/min/1.73m2 or development of proteinuria among participants without CKD at baseline) and CKD progression (worsening of the stages of eGFR or proteinuria according to the KDIGO guideline among participants with CKD at baseline). Results During a mean follow-up of 4.6 years, 757 (16.7%) new-onset CKD and 193 (19.7%) progression of CKD were observed. Serum uric acid had significant relationship with new-onset CKD even after adjustment for sex, age, obese, hypertension, dyslipidemia, and diabetes mellitus: hazard ratio 1.14 per 1 mg/dL increase, 95% confidence interval 1.07-1.21, P<0.001). On the other hand, serum uric acid did not have significant relationship with CKD progression: hazard ratio 1.08 per 1 mg/dL increase, 95% confidence interval 0.96-1.21, P=0.190). Similar results were observed for hyperuricemia defined as serum uric acid level ≥7mg/dl. Conclusion The findings of the present analysis show that serum uric acid was significantly associated with increased risks of new onset of CKD, but was not associated with progression of CKD in Japanese general population.

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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

Clinical and Experimental Nephrology ◽

10.1007/s10157-021-02042-7 ◽

2021 ◽

Author(s):

Kazuhiro Tada ◽

Toshiki Maeda ◽

Koji Takahashi ◽

Kenji Ito ◽

Tetsuhiko Yasuno ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Uric Acid ◽

Kidney Disease ◽

General Population ◽

Epidemiological Study ◽

Serum Uric Acid ◽

Japanese General Population ◽

New Onset

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Higher serum uric acid level is inversely associated with renal function assessed by cystatin C in a Japanese general population without chronic kidney disease: the KOBE study

BMC Nephrology ◽

10.1186/s12882-019-1291-4 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 5

Author(s):

Sachimi Kubo ◽

Yoko Nishida ◽

Yoshimi Kubota ◽

Aya Higashiyama ◽

Daisuke Sugiyama ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Uric Acid ◽

Kidney Disease ◽

General Population ◽

Serum Uric Acid ◽

Uric Acid Level ◽

Acid Level ◽

Serum Uric Acid Level ◽

Japanese General Population

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MO491ASSOCIATION BETWEEN SERUM URIC ACID LEVEL AND CHRONIC KIDNEY DISEASE INCIDENCE STRATIFIED BY SEX IN MIDDLE-AGED ADULTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab087.0011 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Shingo Nakayama ◽

Michihiro Satoh ◽

Takahisa Murakami ◽

Yukako Tatsumi ◽

Tomoko Muroya ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Uric Acid ◽

Kidney Disease ◽

Serum Uric Acid ◽

Health Check ◽

Middle Aged ◽

Men And Women ◽

Increased Risk ◽

The Mean ◽

Middle Aged Adults

Abstract Background and Aims While previous studies have reported the association between serum uric acid (SUA) and chronic kidney disease (CKD) incidence, the sex differences in this association remain controversial. Therefore, we examined the association between SUA levels and CKD incidence in middle-aged adults stratified by sex using data from a large-scale health check-up. Method We analyzed information from the JMDC database, which included the annual health check-up data of Japanese employees and their dependents aged <75 years. Among those individuals, we analyzed data from 138,511 individuals without CKD, kidney disease, or a history of cardiovascular disease at baseline. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and/or proteinuria. We divided the participants into 9 and 7 groups according to SUA levels for men and women, respectively. A Cox model was applied to assess the adjusted hazard ratios (HRs) for CKD incidence in each SUA level group using an SUA concentration of 4.0–4.9 mg/dL as the reference after adjusting for age, body mass index, current or ex-smoker, current or ex-drinker, diabetes mellitus, dyslipidemia, systolic blood pressure, use of anti-hyperuricemic drugs, and baseline eGFR. Results The mean participant age was 44.1 years, and 29.6% were women. The mean SUA levels were 5.9 mg/dL and 4.1 mg/dL in men and women, respectively. During the mean follow-up period of 4.68 years, 12,589 participants developed CKD. The age-standardized incidence rates for CKD were 17.88/17.80 per 1000 person-years in men/women with SUA concentrations of 4.0–4.9 mg/dL, 209.76 per 1000 person-years in men with SUA ≥11.0 mg/dL, and 73.38 per 1000 person-years in women with SUA ≥ 9.0 mg/dL. The fully adjusted HRs (95% confidence interval [CI], P value) for CKD incidence in the groups with SUA concentrations of <4.0, 10.0–10.9, and ≥11.0 mg/dL compared with those with SUA of 4.0–4.9 mg/dL among men were 1.13 (1.01–1.26, P=0.030), 1.98 (1.32–2.97, P=0.0010), and 3.74 (1.68–8.35, P=0.0013), respectively. In women, the fully adjusted HRs for CKD incidence in the groups with SUA concentrations of <4.0, 8.0–8.9, and ≥9.0 mg/dL were 1.08 (1.01–1.16, P=0.032), 2.39 (1.07–5.35, P=0.034), and 3.20 (0.80–12.8, P=0.10), respectively. Similar results were observed when we performed the sensitivity analysis excluding 8,411 individuals with hypertensive treatment from the main analysis. The HRs for the outcomes caused by the onset of eGFR <60 mL/min/1.73 m2 or proteinuria separately were similar to those for the main results. Conclusion The results of the present study demonstrated an increased risk of CKD in men with SUA concentrations of <4.0 and ≥10.0 mg/dL and <4.0 and ≥8.0 mg/dL in women compared to those with SUA concentrations of 4.0–4.9 mg/dL after adjusting for various covariates. Both high and low SUA levels were risk factors for CKD in middle-aged men and women. Hyperuricemia was demonstrated to cause renal injury due to the intraluminal deposition of uric acid crystals in the renal collecting duct. Hyperuricemia may also induce endothelial dysfunction, activation of the renin-angiotensin system, and induction of inflammation and stimulation of vascular smooth muscle cell proliferation by the induction of cyclooxygenase-2. However, as uric acid is one of the most important antioxidants in human plasma, low SUA levels may increase the risk of CKD incidence through decreased antioxidant activity. These mechanisms are implicated in the pathogenesis of CKD caused by high and low SUA levels. In addition, the SUA levels and ranges associated with increased risks of CKD incidence differed by sex.

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