Abstract
BackgroundIncreasing evidence has shown that albuminuria is related to serum uric acid. Little is known about whether this association may be interrelated via renal handling of uric acid. Therefore, we aim to study urinary uric acid excretion and its association with albuminuria in patients with chronic kidney disease (CKD).MethodsA cross-sectional study of 200 Chinese CKD patients recruited from department of nephrology of Huadong hospital was conducted. Levels of 24 h urinary excretion of uric acid (24-h Uur), fractional excretion of uric acid (FEur) and uric acid clearance rate (Cur) according to gender, CKD stages, hypertension and albuminuria status were compared by a multivariate analysis. Pearson and Spearman correlation and multiple regression analyses were used to study the correlation of 24-h Uur, FEur and Cur with urinary albumin to creatinine ratio (UACR).ResultsThe multivariate analysis showed that 24-h Uur and Cur were lower and FEur was higher in the hypertension group, stage 3–5 CKD and macro-albuminuria group (UACR> 30 mg/mmol) than those in the normotensive group, stage 1 CKD group and the normo-albuminuria group (UACR< 3 mg/mmol) (all P < 0.05). Moreover, males had higher 24-h Uur and lower FEur than females (both P < 0.05). Multiple linear regression analysis showed that UACR was negatively associated with 24-h Uur and Cur (P = 0.021, P = 0.007, respectively), but not with FEur (P = 0.759), after adjusting for multiple confounding factors.ConclusionsOur findings suggested that urinary excretion of uric acid is negatively associated with albuminuria in patients with CKD. This phenomenon may help to explain the association between albuminuria and serum uric acid.
Highlights
Increasing evidence has shown that albuminuria is related to serum uric acid
Β blockers, statins, α-glucosidase inhibitor or insulin were used by the patients with chronic kidney disease (CKD), and these were similar among groups
Age, Body mass index (BMI), estimated glomerular filtration rate (eGFR), serum levels of uric acid (SUA), urinary pH (UpH), urinary albumin to creatinine ratio (UACR), Urinary β2 microglobulin-creatinine ratio (UBCR), urinary volume (UV), fractional excretion of uric acid (FEur), Uric acid clearance rate (Cur) and the proportion of hypertension and hyperuricemia significantly differed in three groups
Summary
Increasing evidence has shown that albuminuria is related to serum uric acid. Little is known about whether this association may be interrelated via renal handling of uric acid. We aim to study urinary uric acid excretion and its association with albuminuria in patients with chronic kidney disease (CKD). Li et al BMC Nephrology (2018) 19:95 many studies have shown that hyperuricemia is common in chronic kidney disease (CKD) and associated with the development and progression of CKD [7,8,9], urinary uric acid excretion in population with CKD is rarely studied. Studies indicated that residual nephrons of the patients with CKD underwent a progressive increase in fractional excretion of uric acid as nephron number decreases. What factors may be involved in renal uric acid excretion are not yet fully understood
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