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

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.

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Hyperuricemia and Impaired Renal Function: A Prospective Cohort Study

Kidney Diseases ◽

10.1159/000511196 ◽

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

Background: 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. Objective: The study aimed to examine the relationship between serum uric acid levels and impaired renal function. Methods: 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 m2. 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 <60 mL/min/1.73 m2 over 3 months. Results: 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 (r = −0.213, p < 0.001). Conclusion: 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.

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

10.21203/rs.2.12363/v1 ◽

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

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Sauna Bathing and Risk of Psychotic Disorders: A Prospective Cohort Study

Medical Principles and Practice ◽

10.1159/000493392 ◽

2018 ◽

Vol 27 (6) ◽

pp. 562-569 ◽

Cited By ~ 1

Author(s):

Tanjaniina Laukkanen ◽

Jari A. Laukkanen ◽

Setor K. Kunutsor

Keyword(s):

Psychotic Disorders ◽

Cox Regression ◽

Well Being ◽

Population Based ◽

Hazard Ratio ◽

Male Population ◽

Cox Regression Analysis ◽

Sauna Bathing ◽

General Male Population ◽

Independent Association

Objective: Sauna bathing has been suggested to promote mental well-being and relaxation, but the evidence is uncertain with respect to mental disorders. We aimed to assess the association of frequency of sauna bathing with risk of psychosis in the Kuopio Ischemic Heart Disease prospective population-based study. Subjects and Methods: Baseline sauna bathing habits were assessed in 2,138 men aged 42–61 years who had no history of psychotic disorders. Participants were classified into three groups based on the frequency of sauna bathing (once, 2–3, and 4–7 times per week). Results: During a median follow-up of 24.9 years, 203 psychotic disorders were recorded. A total of 537, 1,417, and 184 participants reported having a sauna bath once a week, 2–3 times, and 4–7 times per week, respectively. In Cox regression analysis adjusted for age, compared to men who had 1 sauna session per week, the hazard ratio (95% confidence intervals) of psychosis for 4–7 sauna sessions per week was 0.23 (0.09–0.58). In a multivariable model adjusted for several risk factors and other potential confounders, the corresponding hazard ratio was 0.21 (0.08–0.52). The association was similar after further adjustment for total energy intake, socioeconomic status, physical activity, and C-reactive protein (0.22 [0.09–0.54]) and was unchanged on additional adjustment for duration of a sauna session and temperature of the sauna bath (0.23 [0.09–0.57]). Conclusion: Our study suggests a strong inverse and independent association between frequent sauna bathing and the future risk of psychotic disorders in a general male population.

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The influence of serum uric acid on renal function in patients with calcium or uric acid stone: A population-based analysis

PLoS ONE ◽

10.1371/journal.pone.0182136 ◽

2017 ◽

Vol 12 (7) ◽

pp. e0182136 ◽

Cited By ~ 9

Author(s):

Yoshimi Tanaka ◽

Shingo Hatakeyama ◽

Toshikazu Tanaka ◽

Hayato Yamamoto ◽

Takuma Narita ◽

...

Keyword(s):

Renal Function ◽

Uric Acid ◽

Serum Uric Acid ◽

Population Based ◽

Uric Acid Stone

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Do Children With Constipation Have Increased Risk of Asthma? Real-World Data From a Nationwide Population-Based Cohort Study

Frontiers in Pediatrics ◽

10.3389/fped.2021.714406 ◽

2021 ◽

Vol 9 ◽

Author(s):

Yen-Chu Huang ◽

Meng-Che Wu ◽

Yu-Hsun Wang ◽

James Cheng-Chung Wei

Keyword(s):

Cohort Study ◽

Cox Regression ◽

Population Based ◽

Hazard Ratio ◽

Adjusted Hazard Ratio ◽

Research Database ◽

Real World Data ◽

Childhood Disorders ◽

Cox Regression Analysis ◽

Increased Risk

Background: Asthma is one of the most burdensome childhood disorders. Growing evidence disclose intestinal dysbiosis may contribute to asthma via the gut-lung axis. Constipation can lead to alteration of the gut microbiota. The clinical impact of constipation on asthma has not been researched. Therefore, we aim to assess whether pediatric constipation influence the risk of developing asthma by a nationwide population-based cohort study.Methods: We analyzed 10,363 constipated patients and 10,363 individuals without constipation between 1999 and 2013 from Taiwan's National Health Insurance Research Database. Analysis of propensity score was utilized to match age, sex, comorbidities, and medications at a ratio of 1:1. In addition, multiple Cox regression analysis was performed to evaluate the adjusted hazard ratio of asthma. Furthermore, sensitivity tests and a stratified analysis were performed.Results: After adjustment for age, sex, comorbidities, and medications, constipated patients had a 2.36-fold greater risk of asthma compared to those without constipation [adjusted hazard ratio (aHR): 2.36, 95% C.I. 2.04–2.73, p < 0.001]. Furthermore, the severity of constipation is associated with an increased risk of asthma; the adjusted hazard ratio was 2.25, 2.85, and 3.44 within < 3, 3–12, and ≥12 times of laxatives prescription within 1 year, respectively (p < 0.001).Conclusion: Constipation was correlated with a significantly increased risk of asthma. Pediatricians should be aware of the possibility of asthma in constipated patients. Further research is warranted to investigate the possible pathological mechanisms of this association.

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Association between uric acid level and incidence of macroalbuminuria in people with type 2 diabetes mellitus: A 4.5-year cohort study

10.21203/rs.2.18350/v1 ◽

2019 ◽

Author(s):

Yun-Ju Lai ◽

Yu-Yen Chen ◽

Li-Jung Chen ◽

Po-Wen Ku ◽

Kuo-Chuan Hung ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Uric Acid ◽

Serum Uric Acid ◽

Cox Regression ◽

Characteristic Curve ◽

Cox Regression Analysis ◽

Increased Risk

Abstract Background: Using animal models and molecular biology researches, hyperuricemia has been shown to instruct renal arteriolopathy, arterial hypertension, and microvascular injury involving the renin-angiotensin system and resulting in renal function impairment. Nevertheless, the association between uric acid levels and the development of macroalbuminuria has been under-investigated in people with type 2 diabetes mellitus. Methods: Patients with type 2 diabetes and regular outpatient visits were recruited from a community hospital in Taiwan since January 2014. Demographics, lifestyle features, and medical history were gathered by well-trained interviewers. All participants underwent comprehensive physical examinations, including a biochemical assay of venous blood specimens and urine samples after an 8-hour overnight fast. Participants were followed until June 2018. The primary outcome was the macroalbuminuria incidence. Univariable and multivariable Cox regression analysis were employed to explore the relation between uric acid and incident macroalbuminuria. Uric acid cutoffs for incident macroalbuminuria were determined with the receiver operator characteristic curve. Results: We included 247 qualified subjects (mean age: 64.78 years old [standard deviation=11.29 years]; 138 [55.87%] men). During a 4.5-year follow-up duration, 20 subjects with incident macroalbuminuria were recognized. Serum uric acid was significantly associated with an increased risk of incident macroalbuminuria (adjusted hazard ratio=2.39; 95% confidence interval: 1.53-3.75; p<0.001) with potential confounders adjustment. The uric acid cutoff point was 6.9 mg/dL (area under the curve 0.708, sensitivity 60.0%, specificity 84.58%) for incident macroalbuminuria. Conclusions: Serum uric acid was associated with incident macroalbuminuria among people with type 2 diabetes.

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Serum Uric Acid Revealed a U-Shaped Relationship With All-Cause Mortality and Cardiovascular Mortality in High Atherosclerosis Risk Patients: The ASSURE Study

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.641513 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yan Cang ◽

Shaojie Xu ◽

Jingyin Zhang ◽

Jingyi Ju ◽

Zijun Chen ◽

...

Keyword(s):

Uric Acid ◽

Regression Model ◽

Serum Uric Acid ◽

Cardiovascular Mortality ◽

Cox Regression ◽

Multicenter Cohort Study ◽

Male And Female ◽

Cox Regression Analysis ◽

All Cause Mortality ◽

Cvd Mortality

Background: Previous studies have demonstrated an association between hyperuricemia and cardiovascular disease (CVD). The Framingham study confirmed that patients with high atherosclerotic risks (HARs) had worse prognoses. However, after adjusting for confounding factors, the association between serum uric acid (SUA) and all-cause mortality and cardiovascular mortality remains unclear, especially for HAR patients.Objective: The aim of this study was to reveal the relationship of SUA with all-cause and cardiovascular mortality in HAR patients.Methods: This multicenter cohort study enrolled 3,047 participants, and the follow-up was 68.85 ± 11.37 months. Factors related to cardiovascular and all-cause mortality were tested by multivariate Cox regression analysis. Restricted cubic splines (RCSs) with knots were used to explore the shape of the dose–response relationship with SUA and the hazard ratio (HR) of all-cause and CVD mortality. SUA transformed by RCS was added to the Cox regression model as an independent variable, and all-cause and CVD mortality scores were calculated. Survival receiver operating characteristic curves were produced using a regression model predicting the score.Results: SUA demonstrated a “U-shaped” relationship with all-cause and cardiovascular mortality. SUA predicted all-cause and CVD mortality, with cutoff values of values of >370.5 μmol/L for males and >327.65 μmol/L for females and <180.5 μmol/L for males and <165.7 μmol/L for females, respectively. The survival ROC curve indicated that SUA is able to predict all-cause and CVD mortality, with areas under the curve of 0.702 and 0.711, respectively. The HRs of all-cause mortality (male and female) with hyperuricemia and hypouricemia were 2.08 and 2.01 and 2.04 and 1.98, respectively, and the HRs of CVD mortality (male and female) were 2.09 and 1.79, and 2.02 and 1.89, respectively.Conclusion: Abnormal SUA levels were significant and independent risk factors for all-cause and CVD mortality. Hyperuricemia and hypouricemia increased mortality in both males and females. Routine SUA evaluation and intensive management are needed for HAR patients.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03616769.

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Role of elevated serum uric acid levels at the onset of overt nephropathy in the risk for renal function decline in patients with type 2 diabetes

Journal of Diabetes Investigation ◽

10.1111/jdi.12243 ◽

2014 ◽

Vol 6 (1) ◽

pp. 98-104 ◽

Cited By ~ 11

Author(s):

Kentaro Tanaka ◽

Shigeko Hara ◽

Masakazu Hattori ◽

Ken Sakai ◽

Yukiko Onishi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Renal Function ◽

Uric Acid ◽

Serum Uric Acid ◽

Elevated Serum ◽

Overt Nephropathy ◽

Renal Function Decline

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An evaluation of longitudinal changes in serum uric acid levels and associated risk of cardio-metabolic events and renal function decline in gout

PLoS ONE ◽

10.1371/journal.pone.0193622 ◽

2018 ◽

Vol 13 (2) ◽

pp. e0193622 ◽

Cited By ~ 15

Author(s):

Rishi J. Desai ◽

Jessica M. Franklin ◽

Julia Spoendlin-Allen ◽

Daniel H. Solomon ◽

Goodarz Danaei ◽

...

Keyword(s):

Renal Function ◽

Uric Acid ◽

Serum Uric Acid ◽

Renal Function Decline ◽

Longitudinal Changes

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Serum Uric Acid Levels Predict Mortality Risk in Male Amyotrophic Lateral Sclerosis Patients

Frontiers in Neurology ◽

10.3389/fneur.2021.602663 ◽

2021 ◽

Vol 12 ◽

Author(s):

Liu-Qing Xu ◽

Wei Hu ◽

Qi-Fu Guo ◽

Guo-Rong Xu ◽

Ning Wang ◽

...

Keyword(s):

Uric Acid ◽

Serum Uric Acid ◽

Cox Regression ◽

Age Of Onset ◽

Diagnostic Delay ◽

Related Factors ◽

Baseline Serum ◽

Cox Regression Analysis ◽

Risk Of Death ◽

Als Patients

Objective: To explore the associations between serum uric acid levels with survival in male and female ALS patients.Methods: A longitudinal cohort study was carried out including 313 sporadic and 16 familial ALS patients with repeated serum uric acid measurements. Multivariate Cox regression models were used to evaluate the survival-related factors.Results: There were 207 male and 122 female, and the mean age of onset was 55.7 ± 11.2 years old. The male patients had significantly higher baseline uric acid levels than that in female patients (342.4 ± 91.4 vs. 279.3 ± 71.4 μmol/L; p < 0.0001). The uric acid levels were inversely associated with the decline rate of ALSFRS-R per month (ΔALSFRS-R). After multivariate Cox regression analysis, a survival advantage was found in male, but not female, with higher serum uric acid levels. In males, a shorter diagnostic delay (≤10 m), lower BMI at baseline (≤18.70 kg/m2), faster disease progression (ΔALSFRS-R > 0.63), and lower baseline uric acid levels (≤292 μmol/L, HR: 1.936; 95% CI: 1.334–2.810) were associated with a shorter survival. During follow-up, the serum uric acid levels were not significantly altered over time.Conclusion: There is an inverse correlation between baseline serum uric acid levels and risk of death, prominently in male ALS patients.

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