Department of Preventive Medicine and Public Health, Kitasato University School of Medicine, Sagamihara, Japan.
BMC Nephrol. 2011 Jul 2;12:31. doi: 10.1186/1471-2369-12-31.
Hyperuricemia is prevalent in patients with chronic kidney disease (CKD). We explored the hypothesis that asymptomatic hyperuricemia may be associated with new-onset CKD.
The participants were all male factory workers in Kanagawa, Japan (n = 1,285). All were over 40 years of age and had undergone annual health examinations from 1990 to 2007. Individuals with a history of gouty attacks were excluded from the study. A retrospective cohort study was conducted by following the estimated glomerular filtration rate (eGFR) for each participant over a maximum period of 18 years. The endpoint was new-onset CKD defined as eGFR < 60 mL/min/1.73 m2. The associations between new-onset CKD and the presence of hyperuricemia, low serum high-density lipoprotein cholesterol, hypertension, diabetes, and obesity were analyzed.
The mean (± standard deviation) follow-up period was 95.2 (± 66.7) months, and new-onset CKD was observed in 100 participants (7.8%) during this follow-up. Cox proportional hazards model revealed that the hazard ratio of new-onset CKD due to hyperuricemia, low serum high-density lipoprotein cholesterol, hypertension and obesity were 3.99 (95% confidence interval: 2.59-6.15), 1.69 (1.00-2.86), 2.00 (1.29-3.11) and 1.35 (0.87-2.10), respectively. Concerning hyperuricemia, low serum high-density lipoprotein cholesterol, hypertension and obesity, the log-rank tests showed P values of < 0.01, 0.01, < 0.01 and < 0.01, respectively.
The results of this study suggest that asymptomatic hyperuricemia is a predictive factor for new-onset CKD for Japanese male workers.
高尿酸血症在慢性肾脏病(CKD)患者中较为普遍。我们提出了一个假设,即无症状性高尿酸血症可能与新发 CKD 相关。
参与者均为日本神奈川县的男性工厂工人(n=1285)。所有人年龄均超过 40 岁,并于 1990 年至 2007 年期间接受了年度健康检查。有痛风发作史的个体被排除在研究之外。通过对每位参与者的估计肾小球滤过率(eGFR)进行最长 18 年的随访,进行了一项回顾性队列研究。新发 CKD 的终点定义为 eGFR<60 mL/min/1.73 m2。分析了新发 CKD 与高尿酸血症、低血清高密度脂蛋白胆固醇、高血压、糖尿病和肥胖的相关性。
平均(±标准差)随访时间为 95.2(±66.7)个月,在此期间有 100 名参与者(7.8%)发生了新发 CKD。Cox 比例风险模型显示,高尿酸血症、低血清高密度脂蛋白胆固醇、高血压和肥胖导致新发 CKD 的风险比分别为 3.99(95%置信区间:2.59-6.15)、1.69(1.00-2.86)、2.00(1.29-3.11)和 1.35(0.87-2.10)。关于高尿酸血症、低血清高密度脂蛋白胆固醇、高血压和肥胖,对数秩检验的 P 值分别<0.01、0.01、<0.01 和<0.01。
这项研究的结果表明,无症状性高尿酸血症是日本男性工人新发 CKD 的预测因素。