School of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
Department of Medicine and Nursing, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil.
Sci Rep. 2022 Apr 15;12(1):6251. doi: 10.1038/s41598-022-10118-x.
The function of uric acid (UA) in the genesis and evolution of chronic kidney disease (CKD) has motivated numerous studies, but the results remain inconclusive. We sought to conduct a systematic review and meta-analysis of cohort studies aiming to analyze the association of UA levels with the incidence and progression of CKD. Pubmed/Medline, Lilacs/Bireme and Web of Science were searched to identify eligible studies, following the PRISMA protocol. Data were presented for CKD incidence and progression separately. For the meta-analysis, studies with data stratified by subgroups according to serum UA levels were selected. The inverse variance-weighted random effects model was used to generate a combined effect estimate. Meta-regressions were performed to identify the causes of heterogeneity. The Newcastle-Ottawa Scale was used to assess the risk of bias. The publication bias was tested by funnel plot and Egger's test. Eighteen CKD incidence studies (n = 398,663) and six CKD progression studies (n = 13,575) were included. An inverse relationship was observed between UA levels and protection from CKD incidence and progression. Lower UA levels were protective for the risk of CKD incidence (RR 0.65 [95% CI 0.56-0.75]) and progression (RR 0.55 [95% CI 0.44-0.68]). UA seems to be implicated both in the genesis of CKD and its evolution.
尿酸（UA）在慢性肾脏病（CKD）发生和进展中的作用激发了众多研究，但结果仍不确定。我们旨在对队列研究进行系统回顾和荟萃分析，以分析 UA 水平与 CKD 发病率和进展的相关性。根据 PRISMA 协议，检索了 Pubmed/Medline、Lilacs/Bireme 和 Web of Science 以确定合格的研究。分别呈现 CKD 发病率和进展的数据。对于荟萃分析，选择了根据血清 UA 水平分层数据的研究。采用逆方差加权随机效应模型生成综合效应估计值。进行荟萃回归以确定异质性的原因。使用纽卡斯尔-渥太华量表评估偏倚风险。通过漏斗图和 Egger 检验测试发表偏倚。纳入了 18 项 CKD 发病率研究（n=398663）和 6 项 CKD 进展研究（n=13575）。UA 水平与 CKD 发病率和进展的保护作用呈负相关。较低的 UA 水平可降低 CKD 发病率（RR 0.65 [95% CI 0.56-0.75]）和进展（RR 0.55 [95% CI 0.44-0.68]）的风险。UA 似乎既参与 CKD 的发生，也参与其进展。
