scholarly journals Hyperuricemia and Impaired Renal Function: A Prospective Cohort Study

2020 ◽  
pp. 1-9
Author(s):  
Noppawit Aiumtrakul ◽  
Puvanant Wiputhanuphongs ◽  
Ouppatham Supasyndh ◽  
Bancha Satirapoj
Keyword(s):  
Renal Function ◽  
Uric Acid ◽  
Regression Analysis ◽  
Cohort Study ◽  
Serum Uric Acid ◽  
Prospective Cohort ◽  
Impaired Renal Function ◽  
Cox Regression ◽  
Community Based ◽  
Cox Regression Analysis

<b><i>Background:</i></b> Related studies have demonstrated a relationship of elevated serum uric levels with a decline in kidney function. However, limited evidence exists in a Southeast Asian community-based population. <b><i>Objective:</i></b> The study aimed to examine the relationship between serum uric acid levels and impaired renal function. <b><i>Methods:</i></b> A prospective cohort study was conducted in the Thai army health checkup population between July 1, 2006 and December 31, 2012. Inclusion criteria included age older than 20 years and baseline estimated glomerular filtration rate (eGFR) over 60 mL/min/1.73 m<sup>2</sup>. Cox regression analysis was used to evaluate the association between incidence of impaired renal function and baseline serum uric acid quartiles. Impaired renal function was defined as eGFR &#x3c;60 mL/min/1.73 m<sup>2</sup> over 3 months. <b><i>Results:</i></b> A total of 9,534 participants (7,474 men and 2,060 women) were enrolled. Cox regression analysis revealed a significant association of serum uric acid level with impaired renal function in the whole population as the unadjusted hazard ratio (HR) (95% CI) of impaired renal function in second, third, and fourth quartiles were 2.1 (1.39, 3.17), 2.39 (1.6, 3.59), and 3.94 (2.71, 5.74), respectively, when compared with serum uric acid in the first quartile, respectively. After adjusting in 2 models, the HR still significantly persisted with similar magnitudes in all quartiles. Higher incidences of impaired renal function were observed among males than among females in all quartiles. Kaplan-Meier curve showed better renal survival rate in the lower quartile groups. Linear regression analysis showed that eGFR negatively correlated with serum uric acid (<i>r</i> = −0.213, <i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> Our study suggests that an independent association exists of serum uric acid levels with the incidence of impaired renal function and renal progression in the Southeast Asian community-based population.

scholarly journals Association between uric acid lowering and renal function progression: a longitudinal study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11073
Author(s):  
Liyi Liu ◽  
Lili You ◽  
Kan Sun ◽  
Feng Li ◽  
Yiqin Qi ◽  
...  
Keyword(s):  
Renal Function ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Regression Models ◽  
Cox Regression ◽  
Population Based ◽  
Hazard Ratio ◽  
Cox Regression Analysis ◽  
Renal Function Decline ◽  
Reduced Risk

Background This study aimed to explore the association between uric acid lowering and renal function. Materials and Methods We conducted a population-based cohort study with 1,534 subjects for 4 years from 2012 to 2016. The population was divided into four groups according to the interquartile range of changes in serum uric acid with quartile 1 representing lower quarter. Renal function decline was defined as eGFR decreased more than 10% from baseline in 2016. Renal function improvement was defined as eGFR increased more than 10% from baseline in 2016. Cox regression analysis was used to calculate the hazard ratio (HR) and 95% confidence interval (CI). Results In the adjusted Cox regression models, compared to quartile 4, quartile 1 (HR = 0.64, 95% CI [0.49–0.85]), quartile 2 (HR = 0.65, 95% CI [0.50–0.84]) and quartile 3 (HR = 0.75, 95% CI [0.58–0.96]) have reduced risk of renal function decline. An increasing hazard ratio of renal function improvement was shown in quartile 1 (HR = 2.27, 95% CI [1.45–3.57]) and quartile 2 (HR = 1.78, 95% CI [1.17–2.69]) compared with quartile 4. Conclusions Uric acid lowering is associated with changes in renal function. The management of serum uric acid should receive attention in clinical practice and is supposed to be part of the treatment of chronic kidney disease.

scholarly journals Hyperuricemia is associated with progression of CKD: uric acid aggravates renal function

2019 ◽  
Author(s):  
Shulei Fan ◽  
Yang Zou ◽  
Amanda Y Wang ◽  
Mingjie Xu ◽  
Guisen Li ◽  
...  
Keyword(s):  
Renal Function ◽  
Uric Acid ◽  
Risk Factor ◽  
Serum Uric Acid ◽  
Metabolic Diseases ◽  
Cox Regression ◽  
Living Standard ◽  
Cox Regression Analysis ◽  
Significant Difference ◽  
The Mean

Abstract Background: With the change of living standard and dietary structure, the incidence of hyperuricemia is on the rise. Hyperuricemia has become one of the metabolic diseases threatening human health. There is paucity of literature on the association between serum uric acid levels and the progression of CKD. This study aimed at assessing the effect of serum baseline uric acid level on the progression of CKD. Methods: This retrospective study included 800 CKD patients in our center. The information on baseline and follow-up characteristics were collected from our Renal Treatment System (RTS) database. Cox regression analysis was used to evaluate the risk factors for CKD progression. The Kaplan–Meier analysis was used to test associations between serum uric acid levels and renal survival rates. Results: A total of 800 patients were included in the study, and the mean age at entry was 36.6±14.4 years. There was no significant difference in gender distribution. The mean eGFR, Cr, serum uric acid at baseline were 99.23±31.54 ml/min/1.73㎡, 82.08±41.40 μmol/L, 371.60±103.18 μmol/L, respectively. 306 (38.3%) patients had HUA and 494 (61.7%) had non-HUA. We established different adjusted models and found that HUA was a risk factor for CKD patients to reach the composite endpoint after adjustment in six models. All models show that HUA was a risk factor for the progression of CKD. Among them, model 4 (adjusted for Cr + Alb + age + BP + gender) was the best model with the largest HR value (HR:2.010, 95%CI:1.310-3.084, P<0.05). The cumulative survival rate of non-hyperuricemia group was higher than that of hyperuricemia group (P<0.001). Conclusions: Hyperuricemia was not only widespread in patients with CKD, but also a risk factor for the progression of CKD. Anti-hyperuricemia therapy may need to be considered in CKD patients to slow the disease progression, which needs to be tested further in clinical studies. Key words: hyperuricemia, chronic kidney disease, renal function, progression

scholarly journals Markers of cholesterol metabolism and cardiovascular outcomes in patients with chronic kidney disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Emrich ◽  
K Rogacev ◽  
M Boehm ◽  
P.C Schulze ◽  
D Fliser ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Regression Analysis ◽  
Impaired Renal Function ◽  
Cox Regression ◽  
Cholesterol Metabolism ◽  
Composite Endpoint ◽  
Cholesterol Absorption ◽  
Dialysis Patients ◽  
Cox Regression Analysis

Abstract Background In dialysis patients statins are less effective than in other high risk patients due to a shift from cholesterol synthesis towards cholesterol absorption. The CARE FOR HOMe study investigates whether a shift towards cholesterol absorption occurs in non-dialysis chronic kidney disease (CKD), and whether the ratio of campesterol-to-lathosterol predicts cardiovascular outcomes in non-dialysis CKD patients. Methods In this analysis 251 participants suffering from CKD (KDIGO 2–4) without lipid-lowering drugs were included and followed for major atherosclerotic events (MACE). Additionally, all-cause death and the composite endpoint MACE and all-cause death were explored. We performed univariate and multivariate Cox regression analysis, adjusting for age, gender, estimated glomerular filtration rate (eGFR), log-transformed albuminuria, prevalent cardiovascular disease, current smoking, diabetes mellitus, systolic blood pressure and body mass index. The primary hypothesis was that patients with a high campesterol-to-lathosterol ratio had a higher event rate. Results Neither lathosterol-to-cholesterol (r=0.022; p=0.730), nor campesterol-to-cholesterol (r=0.041; p=0.519) nor campesterol-to-lathosterol (r=−0.103; p=0.105) correlated with eGFR. During follow-up of 5.1±2.1 years, 47 participants suffered from MACE, 46 participants died and 61 reached the composite endpoint of MACE or all-cause death. In univariate Cox regression analysis, campesterol-to-lathosterol did not predict atherosclerotic cardiovascular events (HR 0.740; 0.368–1.487), all-cause death (HR 0.564; 0.277–1.145) or the composite endpoint (HR 0.652; 0.355–1.196). After full adjustment: campesterol-to-lathosterol was not associated with all three endpoints; MACE (HR 1.064; 0.507–2.231), all-cause death (HR 0.818; 0.420–1.594) and MACE and all-cause death (HR 0.956; 0.525–1.744). Conclusion Markers of cholesterol metabolism were not associated with eGFR in patients with impaired renal function (KDIGO 2–4). Campesterol-to-lathosterol did not predict future MACE or all-cause death in non-dialysis CKD. These findings do not support the concept that patients with impaired renal function (KDIGO 2–4) benefit in particular from ezetimibe treatment. Further research is required to address this hypothesis in dialysis patients. Funding Acknowledgement Type of funding source: None

Serum Uric Acid Levels and Their Changes and Risk of Stroke: A 7-Year Prospective Cohort Study in Northwest China

2021 ◽  
pp. 1-10
Author(s):  
Shan Zheng ◽  
Yan Luo ◽  
Qian Miao ◽  
Zhiyuan Cheng ◽  
Yanli Liu ◽  
...  
Keyword(s):  
Uric Acid ◽  
Cohort Study ◽  
Serum Uric Acid ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Reference Group ◽  
Northwest China ◽  
Stroke Incidence ◽  
Increased Risk ◽  
Over Time

<b><i>Introduction:</i></b> It is not clear whether serum uric acid (SUA) levels and their changes over time are associated with the risk of stroke. A 7-year prospective cohort study in northwest China was conducted to analyze effects of SUA and their changes on the risk of stroke. <b><i>Methods:</i></b> A total of 23,262 individuals without cardiovascular disease in the Jinchang cohort were followed up for an average of 5.26 years. The Cox proportional hazard model was used to estimate the hazard ratios (HRs) and 95% confidence interval (95% CI) of stroke incidence to SUA and relative changes in SUA. Sensitivity analysis was performed after controlling the effect of renal insufficiency. <b><i>Results:</i></b> Baseline SUA and relative changes in SUA were positively correlated with the incidence of stroke in both males and females (<i>p</i> for overall association &#x3c;0.0001). Stroke risk increased by 4.6% per 10% increase in the relative change of SUA (HR = 1.046, 95% CI, 1.007–1.086). The fully adjusted regression analysis demonstrated that only the large gain (&#x3e;30%) in SUA was associated with an increased risk of stroke by 36.5% (95% CI, 1.8–83.0%), compared with the reference group (participants within ±10% changes in SUA). The same trend was observed in people with normal baseline SUA. In the unadjusted model, the risk of stroke associated with elevated SUA was significantly higher in the hyperuricemia group than in the normal SUA group. <b><i>Conclusion:</i></b> High initial SUA concentration and an increase in SUA concentration over time would increase the risk of stroke, and this means that there is no safe increase in SUA.

Abstract P254: Daytime Napping is Associated With Incident Stroke in Community

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Xuting Jin ◽  
Bin Yan ◽  
Ruohan Li ◽  
Ya Gao ◽  
Jingjing Zhang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cox Regression ◽  
Life Quality ◽  
Health Study ◽  
Sleep Habits ◽  
Community Based ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Registration Number ◽  
The Relationship

Introduction: There are conflicting reports regarding whether daytime napping is a risk factor for cardiovascular events. The purpose of this study was to investigate the relationship between daytime napping and incident stroke within a community-based cohort study. Hypothesis: We assessed the hypothesis that the duration and the frequency of daytime napping may be associated with incident stroke. Methods: Participants without previous stroke were enrolled in the present prospective study from the Sleep Heart Health Study (registration number, NCT00005275). Daytime napping were assessed with a self-reported Sleep Habits Questionnaire. Duration of daytime napping was divided into the following categories: no naps, 0-30 min, 31-60 min, or >60 min. Frequency of naps were categorised as: no naps, 1-2 times/week, 3-4 times/week, 5-6 times/week, or daily. After combining nap duration and frequency, participants were further divided into groups with regular long naps (≥5 times per week and >30 min), regular short naps (≥5 times per week and ≤30 min), irregular naps or no naps. Subsequently, participants were followed up until the first stroke occurred between the date of the completed questionnaire and the final censoring date. Cox regression analysis was used to estimate the relationship between daytime napping and incident stroke. Results: The present study enrolled 4757 participants, of which 220 participants (4.6%) experienced incident stroke during an average follow-up of 10.6 years. There was a higher rate of stroke among participants taking longer and more frequent naps than others. Multivariate Cox regression analysis indicated that, when compared with participants with no naps, those with a nap duration of ≥60 min or of 31-60 min had a higher risk of stroke (HR, 2.182; 95% CI, 1.443-3.301; HR, 1.594; 95% CI, 1.003-2.531, respectively). Moreover, there was an increased risk of stroke among participants taking daily daytime naps (HR, 1.563; 95% CI, 1.059-2.307) or napping 5-6 times per week (HR, 1.548; 95% CI, 1.026-2.335) than those with no naps. And after combining nap duration and frequency, regular long naps and regular short naps were also associated with higher risk of incident stroke (HR, 1.903; 95% CI, 1.182-3.065; HR, 1.451; 95% CI, 1.010-2.084, respectively). Conclusions: In conclusion, daytime napping of long duration and high frequency may increase the risk of incident stroke in community. Modification of sleep habits may improve the life quality among those elderly community-based population.

P3759Comparison of equations for renal function assessment and major adverse outcomes in atrial fibrillation: an analysis from the EORP-AF long-term general registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Boriani ◽  
M Proietti ◽  
C Laroche ◽  
E Fantecchi ◽  
M Popescu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Renal Function ◽  
Regression Analysis ◽  
Creatinine Clearance ◽  
Cox Regression ◽  
Weighted Kappa ◽  
Adverse Outcomes ◽  
The Other ◽  
Cox Regression Analysis

Abstract Background Several equations exist to estimate creatinine clearance according to serum creatinine values and baseline characteristics. The CKD-EPI equation is usually recommended in general population, while the Cockroft-Gault (CG) equation has been used in atrial fibrillation (AF) clinical trials. Purpose To perform a comparison between 6 different equations for evaluation of renal function in AF patients. Methods We calculated CKD-EPI, CG, body surface area adjusted CG (CG BSA), MDRD, BIS1 and FAS equations in AF patients enrolled in the EORP-AF Long-Term General Registry. Outcomes at 1-year follow-up were considered. Results Renal equations were calculated in 7725 patients. According to CKD-EPI mean (SD) creatinine clearance was 69.14 (21.06) mL/min/1.73 m2. Taking CKD-EPI as reference, the MDRD equation showed the highest agreement (weighted kappa [95% CI]: 0.843 [0.833–0.852]), while CK showed the lowest agreement (weighted kappa [95% CI]: 0.593 [0.580–0.606]. The remaining equations showed moderate agreement. Cox regression analysis showed that all equations were inversely associated with all major adverse outcomes [Figure]. The CKD-EPI equation showed modest predictive ability for the three outcomes (c-statistics: any TE/ACS/CV Death: 0.63379; CV Death: 0.68512; All-Cause Death: 0.67183), with all other equations reporting higher c-statistics (delta-c statistic ranging from +0.01497 for FAS equation for any TE/ACS/CV Death to +0.04547 for CG BSA for all-cause death) for all outcomes (all p<0.0001, for any equation for any outcome). Compared to CKD-EPI, all the other equations showed an improvement in prediction of outcomes, according to IDI and NRI, with the exception of FAS equation for any TE/ACS/CV Death. CG BSA equation showed the greatest improvement in prediction of outcomes compared to CKD-EPI (relative IDI: 21.9% for any TE/ACS/CV Death, 28.8% for CV Death, 34.4% for All-Cause Death). Cox Regression Analysis Conclusions Compared to CKD-EPI equation, all the other equations for creatine clearance has stronger associations with adverse outcomes, with the CG BSA reporting the higher yield for all the outcomes considered.

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