The relationship between serum uric acid and chronic kidney disease among Appalachian adults
Loretta Cain1, Anoop Shankar, Alan M Ducatman
1Department of Community Medicine, West Virginia University School of Medicine, Morgantown, WV 26506-9190, USA.
Insights
Higher serum uric acid (SUA) levels are linked to chronic kidney disease (CKD). This study found a significant positive association between elevated SUA and increased risk of developing CKD in adults.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Epidemiology
Background:
- Elevated serum uric acid (SUA) is linked to cardiovascular disease and hypertension, a CKD risk factor.
- The independent association between SUA and chronic kidney disease (CKD) remains unclear.
- This study investigated the hypothesis that higher SUA levels are positively associated with CKD.
Purpose of the Study:
- To determine if serum uric acid (SUA) is independently associated with chronic kidney disease (CKD).
- To quantify the association between different levels of SUA and the prevalence of CKD.
Main Methods:
- Analysis of data from the C8 Health Study, a population-based cohort of 49,295 Appalachian adults.
- Serum uric acid (SUA) levels were analyzed in gender-specific quartiles.
- Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m².
Main Results:
- A significant positive association was observed between increasing quartiles of SUA and CKD.
- Compared to the lowest quartile, odds ratios for CKD in higher SUA quartiles were 1.53, 2.16, and 4.67.
- This association remained significant and consistent in analyses stratified by gender.
Conclusions:
- Higher serum uric acid (SUA) levels are independently associated with chronic kidney disease (CKD).
- The findings suggest that CKD may mediate a portion of the association between SUA and cardiovascular disease.
Background:
Higher serum uric acid (SUA) levels have been shown to be associated with cardiovascular disease. SUA levels are also associated with hypertension, a strong risk factor for chronic kidney disease (CKD). However, it is unclear whether SUA is independently associated with CKD. We examined the hypothesis that higher SUA levels are positively associated with CKD.
Methods:
We analysed data from the C8 Health Study, a population-based study of Appalachian adults aged ≥18 years and free of cardiovascular disease (n = 49,295, 53% women). SUA was examined as gender-specific quartiles. The outcome of interest was CKD (n = 2,980), defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m(2) from serum creatinine.
Results:
Overall, we observed a clear positive association between increasing quartiles of SUA and CKD, independent of confounders. Compared with the lowest quartile of SUA (referent), the multivariable odds ratios (95% confidence interval) for quartiles 2-4, respectively, of CKD were 1.53 (1.31, 1.78), 2.16 (1.86 2.50) and 4.67 (4.07, 5.36); P-trend < 0.0001. This observed positive association persisted in separate analysis among men (P-trend < 0.0001) and women (P-trend < 0.0001).
Conclusions:
In conclusion, higher SUA levels are positively associated with CKD, suggesting that at least part of the reported association between SUA and cardiovascular disease may be mediated by CKD.
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