Department of Nephrology, Huadong Hospital Affiliated to Fudan University, No. 221 West Yan'an Road, Shanghai, 200040, People's Republic of China.
Shanghai Key Laboratory of Clinical Geriatric Medicine, No. 221 West Yan'an Road, Shanghai, 200040, People's Republic of China.
Int Urol Nephrol. 2021 Aug;53(8):1665-1674. doi: 10.1007/s11255-020-02754-x. Epub 2021 Jan 2.
Clinical classification of hyperuricemia (HUA) could help to guide therapy of HUA. Studies on the classification of HUA with chronic kidney disease (CKD) are rare. Therefore, we aimed to investigate the classification of HUA with CKD.
A cross-sectional study of 428 CKD patients was conducted, including 218 HUA patients. By correlation analysis, the association of 24-h urinary uric acid (24-h Uur), uric acid clearance rate (Cur), the urinary uric acid excretion per kilogram of weight per hour (Eur) and fractional excretion of uric acid (FEur) with estimated glomerular filtration rate (eGFR) was analyzed in the HUA and non-HUA groups. According to Eur combined with Cur and the 24-h Uur combined with FEur, HUA with CKD was classified into underexcretion, renal overload, combined and 'normal' types, which were also stratified by CKD stages.
According to the Eur and Cur, in early CKD (eGFR ≥ 60 mL/min/1.73 m), the underexcretion type accounted for 83.75%, and the renal overload type accounted for 2.5%. As the CKD stage increased, the proportion of the underexcretion type increased. According to the 24-h Uur and FEur, in early CKD, the underexcretion type accounted for 53.75%, and the renal overload type accounted for 15%. With increasing CKD stages, the proportion of the 'normal' type increased significantly.
Different uses of Eur with Cur or 24-h Uur with FEur varied significantly in classifying HUA patients with CKD. Eur + Cur may be more applicable to the classification of HUA patients with CKD, and further research is needed.
高尿酸血症（HUA）的临床分类有助于指导 HUA 的治疗。关于 HUA 合并慢性肾脏病（CKD）的分类研究较少。因此，我们旨在研究 HUA 合并 CKD 的分类。
对 428 例 CKD 患者进行横断面研究，其中包括 218 例 HUA 患者。通过相关性分析，在 HUA 组和非 HUA 组中分析 24 小时尿尿酸（24-h Uur）、尿酸清除率（Cur）、尿酸每公斤体重每小时排泄量（Eur）和尿酸排泄分数（FEur）与估计肾小球滤过率（eGFR）的相关性。根据 Eur 结合 Cur 和 24-h Uur 结合 FEur，将 HUA 合并 CKD 分为排泄不足、肾脏过载、混合和“正常”型，并按 CKD 分期进行分层。
根据 Eur 和 Cur，在早期 CKD（eGFR≥60 mL/min/1.73 m 2 ）中，排泄不足型占 83.75%，肾脏过载型占 2.5%。随着 CKD 分期的增加，排泄不足型的比例增加。根据 24-h Uur 和 FEur，在早期 CKD 中，排泄不足型占 53.75%，肾脏过载型占 15%。随着 CKD 分期的增加，“正常”型的比例显著增加。
Eur 结合 Cur 或 24-h Uur 结合 FEur 用于 CKD 合并 HUA 患者的分类有显著差异。Eur+Cur 可能更适用于 CKD 合并 HUA 患者的分类，需要进一步研究。
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