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Serum uric acid and the incidence of CKD and hypertension
Satoru Kuriyama1, Yukio Maruyama2, Shinichiro Nishio2
1Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan. kuriyamas218@yahoo.co.jp.
Insights
High uric acid (UA) levels are linked to developing new hypertension, but not to the incidence of chronic kidney disease (CKD). This 4-year cohort study analyzed 8223 participants to understand UA
Area of Science:
- Nephrology
- Cardiology
- Metabolic Health
Background:
- Uric acid (UA) levels are known to correlate with chronic kidney disease (CKD) and hypertension prevalence.
- The relationship between UA levels and the *new* incidence of these conditions requires further investigation.
Purpose of the Study:
- To test the hypothesis that elevated UA levels may predict the new incidence of CKD and hypertension.
- To quantify the association between UA levels and the development of CKD and hypertension over a 4-year period.
Main Methods:
- A 4-year prospective cohort study involving 8223 participants initially free of CKD.
- Analysis included 7569 participants for hypertension incidence, using UA levels as the primary predictor.
- Statistical methods included Chi-square tests, Cox proportional hazard analysis, logistic analysis, and Kaplan-Meier analysis.
Main Results:
- Higher UA levels showed a significant association with the new development of hypertension (p < 0.001).
- Elevated UA levels (≥7 mg/dL) were associated with increased odds of developing hypertension (OR 1.33).
- No significant association was found between UA levels and the incidence of CKD.
Conclusions:
- High UA levels are a significant risk factor for the new development of hypertension.
- UA levels do not appear to be associated with the incidence of CKD in this cohort.
Background:
Uric acid (UA) levels correlate positively with the prevalence of chronic kidney disease (CKD) and/or hypertension. We tested the hypothesis that UA may also have a link to a new incidence of CKD and hypertension.
Methods:
Study design is a cohort study and the predictor is UA levels. Of the 15,470 screened cases, 8223 participants without CKD were eligible for the analysis of the incidence of CKD. Among these CKD candidates, 7569 participants were eligible for the analysis of the new development of hypertension. The observation period was 4 years.
Results:
Relationship of UA with new cases of CKD. Higher UA levels had a closer association with the new development of CKD; 1.1 % (UA < 5 mg/dL), 1.5 % (5.0-5.9 mg/dL), 1.7 % (6.0-6.9 mg/dL), and 3.4 % (≧7 mg/dL), respectively (p < 0.001 by the Chi-square test). Cox proportional hazard analysis showed that the estimates of the CKD development were eGFR [Hazard Ratio (HR) 0.816, 95 % confidence intervals (CI) 0.791-0.840] and male gender (HR 0.562, 95 % CI 0.322-0.982). UA levels and new development of hypertension. Higher UA levels had a closer association with the new development of hypertension; 5.0 % (UA < 5 mg/dL), 8.9 % (5.0-5.9 mg/dL), 10.6 % (6.0-6.9 mg/dL), and 11.8 % (≧7 mg/dL), respectively (p < 0.001 by the Chi-square test). Cox proportional hazard analysis showed that the estimates of the hypertension development were BMI (HR 1.190, 95 % CI 1.155-1.226), age (HR 1.021, 95 % CI 1.010-1.032), HDL-cholesterol (HR 1.013, 95 % CI 1.007-1.019), male gender (HR 1.791, 95 % CI 1.338-2.395), UA level (HR 1.112, 95 % CI 1.024-1.207), and eGFR (HR 1008, 95 % CI 1.002-1.013). Furthermore, the logistic analysis showed that the odds ratio (OR) to estimate hypertension in the high UA group (UA ≧ 7 mg/dL; OR 1.33, 95 % CI 1.01-1.80) was greater than that in the low UA group (UA < 5 mg/dL). Kaplan-Meier analysis also confirmed the finding that the higher the UA levels the greater the hypertension development (p < 0.001 by the Log-rank test and Cox proportional hazard analysis).
Conclusion:
High UA levels are associated with the new development of hypertension, but not with the incidence of CKD.
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