Abstract
BackgroundHyperuricemia (HUA) is very common in chronic kidney disease (CKD). HUA is associated with an increased risk of cardiovascular events and accelerates the progression of CKD. Our study aimed to explore the relationship between baseline serum uric acid levels and renal histopathological features.MethodsOne thousand seventy patients receiving renal biopsy in our center were involved in our study. The baseline characteristics at the time of the kidney biopsy were collected from Renal Treatment System (RTS) database, including age, gender, serum uric acid (UA), glomerular filtration rate (eGFR), serum creatinine (Cr), urea, albumin (Alb), 24 h urine protein quantitation (24 h-u-pro) and blood pressure (BP). Pathological morphological changes were evaluated by two pathologists independently. Statistical analysis was done using SPSS 21.0.ResultsAmong 1070 patients, 429 had IgA nephropathy (IgAN), 641 had non-IgAN. The incidence of HUA was 38.8% (n = 415), 43.8% (n = 188), and 43.2% (n = 277) in all patients, patients with IgAN and non-IgAN patients, respectively. Serum uric acid was correlated with eGFR (r = − 0.418, p < 0.001), Cr (r = 0.391, p < 0.001), urea (r = 0.410, p < 0.001), 24-u-pro (r = 0.077, p = 0.022), systolic blood pressure (SBP) (r = 0.175, p < 0.001) and diastolic blood pressure (DBP) (r = 0.109, p = 0.001). Multivariate logistic regression analysis showed that after adjustment for Cr, age and blood pressure, HUA was a risk factor for segmental glomerulosclerosis (OR = 1.800, 95% CI:1.309–2.477) and tubular atrophy/interstitial fibrosis (OR = 1.802, 95% CI:1.005–3.232). HUA increased the area under curve (AUC) in diagnosis of segmental glomerulosclerosis.ConclusionsHyperuricemia is prevalent in CKD. The serum uric acid level correlates not only with clinical renal injury indexes, but also with renal pathology. Hyperuricemia is an independent risk factor for segmental glomerulosclerosis and tubular atrophy/interstitial fibrosis.
Highlights
Hyperuricemia (HUA) is very common in chronic kidney disease (CKD)
The patients with IgA nephropathy (IgAN) had a higher ratio of segmental glomerulosclerosis and more serious situation of
We attempted to divide the 1070 patients into different subgroups according to renal pathology, such as IgAN, membranous nephropathy (MN) group, focal segmental glomerulosclerosis (FSGS), etc
Summary
Hyperuricemia (HUA) is very common in chronic kidney disease (CKD). HUA is associated with an increased risk of cardiovascular events and accelerates the progression of CKD. Hyperuricemia (HUA) is associated with endothelial dysfunction, vascular smooth muscle proliferation and interstitial inflammatory infiltration through a variety of mechanisms, such as inducing intracellular oxidative stress, Hyperuricemia is a common phenomenon in patients with chronic kidney disease (CKD). Previous studies have shown that hyperuricemia was a risk factor for CKD [8, 9] It can accelerate the progression of CKD [10,11,12,13], and increase the incidence of cardiovascular, cerebrovascular diseases and metabolic diseases [14,15,16,17]. The correlation between hyperuricemia and renal pathological changes is not entirely clear
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