Abstract
Background and objectivesThe aim of the study was to examine the associations of uric acid (UA) in blood and urine with subclinical renal damage (SRD) and its progression in a Chinese cohort.Methods1) 2342 participants from our previously established cohort who were followed up in 2017 were included. Cross-sectional analysis was used to examine the relationships between serum and urinary UA and the risk of SRD. 2) A total of 266 participants were recruited from the same cohort in 2013, and followed up in 2017. Longitudinal analysis was used to determine the relationships of serum and urinary UA with progression of SRD, which was defined as urinary albumin-to-creatinine ratio (uACR) progression or estimated glomerular filtration rate (eGFR) decline.ResultsIn cross-sectional analysis, higher levels of uACR were associated with higher levels of serum uric acid (SUA) and urinary uric acid/creatinine ratio (uUA/Cre). Lower eGFR was associated with higher levels of SUA and fractional excretion of uric acid (FEUA) but lower uUA/Cre levels in all subjects. In addition, the multivariate-adjusted odds ratios for SRD compared with non-SRD were 3.574 (2.255–5.664) for uUA/Cre. Increasing uUA/Cre levels were associated with higher risk of SRD. In longitudinal analysis, 4-year changes of uUA/Cre and SUA were significantly associated with eGFR decline.ConclusionsThis study suggested that urinary UA excretion was significantly associated with the risk of SRD in Chinese adults. Furthermore, 4-year changes of serum and urinary UA were associated with SRD progression. These findings suggest that UA, especially urinary UA, may be used as a simple, noninvasive marker for early detection of decreased renal function in otherwise healthy subjects.
Highlights
Chronic kidney disease (CKD) has become a major public health issue because of the global prevalence and the associated increase in the incidence of cardiovascular disease and premature death [1,2]
In cross-sectional analysis, higher levels of urinary albumin-to-creatinine ratio (uACR) were associated with higher levels of serum uric acid (SUA) and urinary uric acid/creatinine ratio
Lower estimated GFR (eGFR) was associated with higher levels of SUA and fractional excretion of uric acid (FEUA) but lower urinary uric acid/creatinine ratio (uUA/Cre) levels in all subjects
Summary
Chronic kidney disease (CKD) has become a major public health issue because of the global prevalence and the associated increase in the incidence of cardiovascular disease and premature death [1,2]. Recent clinical and cohort studies suggest that hyperuricaemia is a risk factor for cardiovascular events and renal disease [8,9]. Few studies have indicated that hyperuricaemia is associated with subclinical renal damage (SRD), defined as slightly increased albuminuria or decreased estimated GFR (eGFR), in hypertensive patients [13,14]. Such an association is still unclear in the general population, especially for people who are non-hypertensive and non-diabetic. The aim of the study was to examine the associations of uric acid (UA) in blood and urine with subclinical renal damage (SRD) and its progression in a Chinese cohort.
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