Association of Uric Acid and Left Ventricular Mass Index With Renal Outcomes in Chronic Kidney Disease

Abstract

Hyperuricemia and left ventricular (LV) hypertrophy are prevalent in chronic kidney disease (CKD), but the association of uric acid (UA) and left ventricular mass index (LVMI) with renal outcomes in patients with CKD is unclear. We conducted a study to assess whether the combination of UA and LVMI is associated with renal outcomes in patients with CKD of stages 3-5. This longitudinal study enrolled 540 patients, who were classified into four groups according to sex-specific median values of UA and LVMI. The study investigated the associations of the study groups with progression to dialysis, rapid progression of decline in renal function (decline in estimated glomerular filtration rate (eGFR) > 3ml/min/1.73 m(2)/year), and change in eGFR, using Cox proportional hazards modeling, logistic regression analysis, and linear mixed-effects modeling, respectively. The follow-up period for the study was 33.4 (19.8-39.6) months. The average number of serum creatinine measurements during the follow-up period was 8 (range, 5-12). Multivariate analyses demonstrated an association of the group with a higher UA and LVMI with an increased rate of progression to dialysis (hazard ratio (HR), 1.830; 95% confidence interval (CI), 1.007 to 3.326; P = 0.048) and with rapid progression of decline in renal function (odds ratio (OR), 2.231; 95% CI, 1.058-4.705; P = 0.04). Additionally, the linear mixed-effects model showed that the decrease in eGFR over time was more rapid in the group with a higher UA and LVMI than in the other groups (P < 0.04). Our findings show that the combination of a higher UA and LVMI is a risk factor for progression to dialysis and rapid progression of decline in renal function in patients with CKD of stages 3-5.