Kidney Center, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan.
Blood Purification Unit, Hamamatsu University Hospital, Hamamatsu, Japan.
Ren Fail. 2021 Dec;43(1):1408-1415. doi: 10.1080/0886022X.2021.1988969.
Serum uric acid (SUA) levels have a linear relationship with the estimated glomerular filtration rate (eGFR). It is unclear whether further changes, subsequent to normal level of SUA can attenuate eGFR decline in a healthy population, so we aimed to determine the normal level of SUA that can contribute to preventing kidney dysfunction.
In this retrospective cohort study from Japan, annual health checkup data from 2009 to 2014 was collected. After propensity score matching (1:1), data from 2,634 individuals with basal SUA ≤7.0 mg/dL (normal; mean age, 39 y; mean eGFR, 80.8 mL/min/1.73 m) and 1,642 individuals with basal SUA >7.0 mg/dL (elevated; mean age, 42 y; mean eGFR, 75.0 mL/min/1.73 m) were collected to determine the relationship between followed-up SUA level and the rate of change in eGFR.
In individuals with normal level SUA at baseline, the elevation of SUA (>7.0 mg/dL) accelerated eGFR decline compared to those with normal SUA levels at 5-year follow-up (-4.1 ± 9.6% vs -9.9 ± 9.0%, < .0001). Digression of SUA level (≤7.0 mg/dL) reduced eGFR decline compared with persistent SUA level over 7.0 mg/dL (-1.5 ± 11.5% vs -7.0 ± 10.1, < .0001). In multiple linear regression analysis, there was strong association between the rate of change in SUA and eGFR in individuals with basal SUA ≤7.0 and >7.0 mg/dL (standardized coefficient; -0.3348, < .001 and -.2523, < .001, respectively).
Subsequent to normal level of SUA (under 7.0 mg/dL) may contribute to a decrease in eGFR decline in apparently healthy men.
血清尿酸(SUA)水平与估算肾小球滤过率(eGFR)呈线性关系。目前尚不清楚在健康人群中,SUA 水平正常后进一步变化是否可以减缓 eGFR 下降,因此我们旨在确定可以预防肾功能障碍的正常 SUA 水平。
本研究为回顾性队列研究,数据来自日本 2009 年至 2014 年的年度健康检查。采用倾向评分匹配(1:1)后,纳入基础 SUA≤7.0mg/dL(正常组;平均年龄 39 岁;平均 eGFR 80.8mL/min/1.73m)的 2634 人和基础 SUA>7.0mg/dL(升高组;平均年龄 42 岁;平均 eGFR 75.0mL/min/1.73m)的 1642 人,以确定随访 SUA 水平与 eGFR 变化率之间的关系。
在基线时 SUA 水平正常的人群中,与基础 SUA 水平正常但在 5 年随访时升高(>7.0mg/dL)的人群相比,SUA 升高(>7.0mg/dL)加速了 eGFR 下降(-4.1±9.6%比-9.9±9.0%,<.0001)。与持续高于 7.0mg/dL 的 SUA 水平相比,SUA 水平的下降(≤7.0mg/dL)可降低 eGFR 下降速度(-1.5±11.5%比-7.0±10.1%,<.0001)。在多线性回归分析中,基础 SUA≤7.0mg/dL 和>7.0mg/dL 的人群中,SUA 变化率与 eGFR 之间存在很强的关联(标准化系数;-0.3348,<.001 和-.2523,<.001)。
SUA 水平正常(<7.0mg/dL)可能有助于降低肾功能正常男性的 eGFR 下降速度。