a Beilun People's Hospital & the Beilun Branch of the First Affiliated Hospital of School of Medicine , Zhejiang University , Ningbo , Zhejiang , China.
b Kidney Disease Center, Ningbo Medical Center (Li Huili Eastern Hospital) , Ningbo , China.
Ren Fail. 2018 Nov;40(1):666-671. doi: 10.1080/0886022X.2018.1487859.
Uric acid (UA) is a risk marker of CKD and SUA level in CKD 3-4 patients closely correlates with hyperuricemic nephropathy (HN) morbidity. This study was designed to evaluate the risk factors for HN in CKD 3-4 patients.
The 461 CKD 3-4 patients were recruited and all patients were divided into three groups (24 h UUA normal, underexeret, and overproduct type groups) according to the 24 h UUA level after receiving low purine food for five days. Clinical and biochemical characteristics of CKD patients were collected for the logistic regression analysis. Correlation analysis of the mRNA relative expression level of hUAT and hURAT1 with serum UA (SUA) level also was evaluated.
There were significant increases in characteristics including average age, waist-to-height ratio (WHR), SUA levels, HN ratio, TG/HDL ratio, body mass index (BMI), blood pressure (BP), uNgal/Cr. ratio, and uKim-1/Cr. ratio in overproduct type group in comparison with the other two groups. Logistic regression analysis showed SUA, CHO, uKim-1/Cr. ratio and uNgal/Cr. ratio were independent and multiple risk factors for HN. Moreover, hUAT and hURAT1 mRNA relative expression levels were significantly correlated with SUA level in the underexeret type CKD 3-4 patients.
These results showed SUA and other characteristics contributed to HN morbidity in CKD 3-4 patients.
尿酸（UA）是 CKD 的风险标志物，CKD 3-4 患者的 SUA 水平与高尿酸血症性肾病（HN）的发病率密切相关。本研究旨在评估 CKD 3-4 患者发生 HN 的危险因素。
纳入 461 例 CKD 3-4 患者，所有患者均接受 5 天低嘌呤饮食后，根据 24 小时尿尿酸（24 h UUA）水平分为 24 h UUA 正常、排泄减少和生成过多三组。收集 CKD 患者的临床和生化特征进行 logistic 回归分析。还评估了 hUAT 和 hURAT1 的 mRNA 相对表达水平与血清 UA（SUA）水平的相关性。
与其他两组相比，生成过多组的特征包括平均年龄、腰高比（WHR）、SUA 水平、HN 发生率、TG/HDL 比值、体重指数（BMI）、血压（BP）、uNgal/Cr 比值和 uKim-1/Cr 比值均显著增加。logistic 回归分析显示，SUA、CHO、uKim-1/Cr 比值和 uNgal/Cr 比值是 HN 的独立和多危险因素。此外，在排泄减少型 CKD 3-4 患者中，hUAT 和 hURAT1 mRNA 相对表达水平与 SUA 水平呈显著相关。
这些结果表明 SUA 和其他特征导致 CKD 3-4 患者 HN 的发病率增加。
