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血清尿酸与日本一般人群新发和慢性肾脏病进展的关系:动脉粥样硬化和慢性肾脏病的生口流行病学研究。

Association between serum uric acid and new onset and progression of chronic kidney disease in a Japanese general population: Iki epidemiological study of atherosclerosis and chronic kidney disease.

机构信息

Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.

Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan-ku, Fukuoka, 814-0180, Japan.

出版信息

Clin Exp Nephrol. 2021 Jul;25(7):751-759. doi: 10.1007/s10157-021-02042-7. Epub 2021 Mar 10.

Abstract

BACKGROUND

Although several risk factors for chronic kidney disease (CKD) have been proposed, it remains unclear whether elevated serum uric acid (SUA) is negatively association with kidney function. The aim of this study was to elucidate the association between SUA and new onset and progression of CKD in a Japanese general population.

METHODS

This was a population-based retrospective cohort study using annual health checkup data of residents of Iki Island. A total of 5,507 adults (979 with CKD and 4,528 without) were included. The outcomes were new onset of CKD among participants without CKD at baseline, and progression of CKD among those with CKD. A Cox proportional hazards model was used to evaluate the association between SUA and new onset and progression of CKD.

RESULTS

During mean follow-up of 4.6 years, 757 cases of new onset of CKD and 193 with progression of CKD were observed. SUA was significantly associated with new onset of CKD (adjusted hazard ratio 1.13, [95% confidence interval 1.03-1.24] per standard deviation [SD] increase in SUA). In contrast, SUA was not significantly associated with progression of CKD (hazard ratio 1.08, [0.92-1.27] per SD increase). Similar results were obtained when classifying uric acid as categorical.

CONCLUSION

SUA was significantly associated with increased risk for new onset of CKD, but not with progression of CKD among a Japanese general population.

摘要

背景

尽管已经提出了几种慢性肾脏病(CKD)的危险因素,但血清尿酸(SUA)升高是否与肾功能下降呈负相关仍不清楚。本研究旨在阐明日本普通人群中 SUA 与新发和 CKD 进展的关系。

方法

这是一项基于人群的回顾性队列研究,使用了生口岛居民的年度健康检查数据。共纳入 5507 名成年人(979 名患有 CKD,4528 名无 CKD)。结局为无基线 CKD 的参与者中新发 CKD,以及 CKD 患者中 CKD 的进展。采用 Cox 比例风险模型评估 SUA 与新发和 CKD 进展的关系。

结果

在平均 4.6 年的随访期间,观察到 757 例新发 CKD 和 193 例 CKD 进展。SUA 与新发 CKD 显著相关(SUA 每增加一个标准差,调整后的风险比为 1.13 [95%置信区间 1.03-1.24])。相反,SUA 与 CKD 进展无显著相关性(SUA 每增加一个标准差,风险比为 1.08 [0.92-1.27])。将尿酸分类为分类变量时也得到了类似的结果。

结论

SUA 与新发 CKD 的风险增加显著相关,但与日本普通人群中 CKD 的进展无关。

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