Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea.
Nephrol Dial Transplant. 2012 May;27(5):1831-5. doi: 10.1093/ndt/gfr530. Epub 2011 Sep 21.
Both serum uric acid (SUA) and chronic kidney disease (CKD) are associated with the risk of cardiovascular disease; however, it is unclear whether SUA independently increases the risk of CKD based on longitudinal data.
To investigate the relationship between SUA levels and CKD development, we initiated a 10.2-year prospective cohort study. Data from 14 939 Koreans, 20-84 years of age, who completed a questionnaire and medical examination at the Severance Health Promotion Center were evaluated. The outcome of interest, CKD, was defined as an estimated glomerular filtration rate (GFR) of <60 mL/min/1.73m(2) via the simplified Modification of Diet in Renal Disease equation.
A multivariate Cox proportional hazard model, controlling for age, life style and other cardiovascular risk factors, showed an increased risk of developing CKD for men [hazard ratio (HR) 2.1; 95% confidence interval (CI) 1.6-2.9] and women (HR = 1.3; 95% CI = 1.0-1.8) in the highest quartiles of SUA compared to their counterparts in the lowest quartiles. The relationship between SUA and CKD was linear and stepwise in men. The HRs for renal function Grade 2 (75-89.9 mL/min/1.73m(2)), Grade 3 (60-74.9 mL/min/1.73m(2)) and Grade 4 (<60 mL/min/1.73m(2)) increased with an increase in SUA quartiles as compared to the baseline GFR group (Grade 1, ≥90 mL/min/1.73m(2)).
Higher SUA levels increased the risk of CKD, suggesting that at least part of the reported association between SUA and cardiovascular disease may be connected to CKD.
血清尿酸（SUA）和慢性肾脏病（CKD）均与心血管疾病风险相关；然而，基于纵向数据，SUA 是否独立增加 CKD 风险尚不清楚。
为了研究 SUA 水平与 CKD 进展之间的关系，我们开展了一项 10.2 年的前瞻性队列研究。对在首尔大学医院保健中心完成问卷调查和体检的 14939 名 20-84 岁韩国人进行了数据分析。我们将 CKD 定义为简化肾脏病饮食改良公式估算的肾小球滤过率（eGFR）<60mL/min/1.73m2。
在多变量 Cox 比例风险模型中，校正年龄、生活方式和其他心血管危险因素后，SUA 最高四分位组的男性（风险比 [HR] 2.1；95%置信区间 [CI] 1.6-2.9）和女性（HR = 1.3；95% CI 1.0-1.8）发生 CKD 的风险高于最低四分位组。SUA 与 CKD 之间的关系在男性中呈线性和逐步递增趋势。与基线 eGFR 组相比，SUA 四分位组肾功能等级 2（75-89.9mL/min/1.73m2）、等级 3（60-74.9mL/min/1.73m2）和等级 4（<60mL/min/1.73m2）的 HR 随着 SUA 四分位组的增加而升高。
较高的 SUA 水平增加了 CKD 风险，这表明 SUA 与心血管疾病之间的部分关联可能与 CKD 有关。
