Serum uric acid is an independent predictor of renal outcomes in patients with idiopathic membranous nephropathy.

PURPOSE

Accumulating evidence suggests that a relationship exists between serum uric acid (UA) and the progression of chronic kidney disease (CKD), but information regarding idiopathic membranous nephropathy (IMN) is limited.

METHODS

Patients with renal biopsy-confirmed diagnosis of IMN between 2009 and 2017 were identified. The demographic and clinical data recorded at the time of renal biopsy were considered the baseline values. The included cases were separated into three groups based on tertiles of the baseline serum UA level, and the relationship between serum UA and poor renal outcome was investigated by receiver operating characteristic (ROC) and time-event analyses. The primary endpoint was poor renal outcome, which was defined as a decrease in the estimated glomerular filtration rate to 50% of the baseline level or progression to end-stage renal disease during the follow-up.

RESULTS

Of 989 cases, 572 eligible patients were included. During a median of 18 months of follow-up, 45 (7.9%) patients progressed to the primary endpoint. Both baseline serum UA and time-averaged UA levels could be used for discrimination of renal outcomes, but the difference was not significant (p value = 0.6). Our Cox regression analysis further demonstrated that baseline serum UA was an independent predictor of poor renal outcome in IMN patients, and subgroup analysis revealed a gender difference in the predictive effect of serum UA.

CONCLUSIONS

Our study demonstrated that baseline serum UA was an independent predictor of poor renal outcome in patients with IMN, and a gender difference in the predictive effect was observed in our cohort.