Keywords
hyperuricemia
mortality
kidney replacement therapy
renal deterioration
Categories
Abstract
Background
Chronic kidney disease (CKD) has a global prevalence of 9%. Studies have reported an association of hyperuricemia with the progression of CKD, but their conclusions are often contradictory. In this study, we aim to analyse the association between serum uric acid with rapid renal function decline in a tertiary centre in Asia.
Methods
This is retrospective study conducted in a tertiary nephrology clinic. 416 patients were recruited and follow up from 2007 until June 2019. Data were extracted from the electronic health information system. This research has received the necessary ethical clearance by the NMRR and MREC. The Kaplan-Meier survival curve was used to analyse the renal outcomes, which consisted of 50% deterioration of GFR, doubling of the baseline serum creatinine, initiation of kidney replacement therapy (KRT) and mortality.
Results
There is a significant association between hyperuricemia with GFR, serum creatinine and proteinuria. A Kaplan Meier analysis showed a significant association between serum uric acid and the various kidney outcomes, namely the halving of GFR (p = 0.057) and mortality (p = 0.005) but not significant with regards to the need for initiation of kidney replacement therapy or doubling of serum creatinine (57% decline in GFR).
Conclusion
Our study showed hyperuricemia is associated with worsening renal outcomes. Study postulate there may be a certain threshold point of uric acid induced kidney damage which is irreversible. A larger multicentre prospective study is suggest to validate this finding and to study the optimal time to start uric acid lowering agent.
References
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