High levels of uric acid are associated with an increased risk of chronic kidney disease (CKD), especially among hypertensive individuals, according to data presented at the 49th Congress of the European Renal Association-European Dialysis and Transplant Association.
Investigators at Erasmus Medical Center in Rotterdam, The Netherlands, studied 5,139 individuals aged 55 years and older. Each 1 mg/dL increment in serum uric acid level was associated with a 0.22 mL/min/1.73 m2 increase in estimated glomerular filtration rate (eGFR) decline and a 34% increase in the incidence of CKD. The researchers reported that the association was significantly stronger in hypertensive compared with normotensive individuals. When the investigators combined their findings with those of other studies in a meta-analysis, they found that each 1 mg/dL increment in uric acid was associated with a 15% increased risk for CKD.
The researchers concluded that adequate monitoring and management of abnormal serum uric acid levels appears to be important in preventing development of CKD in hypertensive individuals.
The investigators used the Modification of Diet in Renal Disease (MDRD) study equation to calculate eGFR and defined CKD as a decline in eGFR to below 60.
The study is not the first to link higher serum uric acid levels to an increased risk of CKD. In a 10.2-year prospective cohort study involving 14,939 individuals aged 20-84 years who completed medical questionnaires and medical examinations, Yejin Mok, MD, and colleagues at Yonsei University in Seoul, Korea, found that men and women in the highest quartile of serum uric acid had a 2.1 times and 1.3 times increased risk of CKD, respectively, compared with their counterparts in the lowest quartile, after controlling for age, life style and cardiovascular risk factors.
In a report published online ahead of print in Nephrology Dialysis Transplantation, the authors noted that both serum uric acid and CKD are associated with cardiovascular disease (CVD) risk. Their finding of an independent association between higher serum uric acid levels and CKD risk suggests that at least part of the reported association between serum uric acid and CVD may be connected with CKD.
