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Association of Renal Function Deterioration with Baseline Uricosuria
Amnon Gil1,2, Daniel Kushnir3,4, Victor Frajewicki3,4
1Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel, amnongil@clalit.org.il.
Kidney & Blood Pressure Research
|October 2, 2025
Summary
High urinary uric acid (UUA) levels may indicate a higher risk of kidney function decline, specifically a 50% decrease in estimated glomerular filtration rate (eGFR). Further research is needed to confirm the role of uricosuria in kidney disease progression.
Area of Science:
- Nephrology
- Urology
- Internal Medicine
Background:
- Serum uric acid elevation is linked to renal function deterioration.
- The association between baseline urinary uric acid (UUA) levels and kidney function decline is not well-established.
- This study investigates the relationship between UUA levels and renal function decline.
Purpose of the Study:
- To assess the association between baseline urinary uric acid (UUA) levels and renal function decline.
- To compare the risk of composite renal endpoints in patients with hyperuricosuria versus normal UUA levels.
Main Methods:
- Retrospective cohort study including patients with available UUA and eGFR data.
- Study group: UUA ≥750 mg/day; Control group: UUA <750 mg/day.
- Primary endpoint: composite of eGFR decline ≥50%, eGFR <15 mL/min, dialysis, or death. Analyzed using Cox proportional hazards model.
Main Results:
- No significant difference in the composite endpoint between groups (HR: 1.20, p=0.11).
- Significantly higher rate of eGFR decline ≥50% in the hyperuricosuria group (HR: 2.22, p<0.001).
- No significant differences in other secondary endpoints observed.
Conclusions:
- No significant difference in the composite renal endpoint between patients with and without hyperuricosuria.
- Baseline hyperuricosuria is significantly associated with a greater decline in kidney function (eGFR ≥50%).
- Prospective studies are warranted to elucidate the role of uricosuria in renal function deterioration.
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