Longitudinal uric acid has nonlinear association with kidney failure and mortality in chronic kidney disease

We investigated the shape of the relationship between longitudinal uric acid (UA) and the hazard of kidney failure and death in chronic kidney disease (CKD) patients, and attempted to identify thresholds associated with increased hazards. We included CKD stage 3–5 patients from the CKD-REIN cohort w...

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Veröffentlicht in:Scientific reports Jg. 13; H. 1; S. 3952 - 11
Hauptverfasser: Prezelin-Reydit, Mathilde, Combe, Christian, Fouque, Denis, Frimat, Luc, Jacquelinet, Christian, Laville, Maurice, Massy, Ziad A., Lange, Céline, Ayav, Carole, Pecoits-Filho, Roberto, Liabeuf, Sophie, Stengel, Bénédicte, Harambat, Jérôme, Leffondré, Karen
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London Nature Publishing Group UK 09.03.2023
Nature Publishing Group
Nature Portfolio
Schlagworte:
692/4022
692/499
692/53
Aged
Death
Female
Health hazards
Human health and pathology
Humanities and Social Sciences
Humans
Kidney diseases
Kidney Failure, Chronic
Kidneys
Life Sciences
Male
Mortality
multidisciplinary
Proportional Hazards Models
Renal failure
Renal Insufficiency, Chronic - complications
Risk Factors
Science
Science (multidisciplinary)
Uric Acid
ISSN:2045-2322, 2045-2322
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Zusammenfassung:We investigated the shape of the relationship between longitudinal uric acid (UA) and the hazard of kidney failure and death in chronic kidney disease (CKD) patients, and attempted to identify thresholds associated with increased hazards. We included CKD stage 3–5 patients from the CKD-REIN cohort with one serum UA measurement at cohort entry. We used cause-specific multivariate Cox models including a spline function of current values of UA (cUA), estimated from a separate linear mixed model. We followed 2781 patients (66% men, median age, 69 years) for a median of 3.2 years with a median of five longitudinal UA measures per patient. The hazard of kidney failure increased with increasing cUA, with a plateau between 6 and 10 mg/dl and a sharp increase above 11 mg/dl. The hazard of death had a U-shape relationship with cUA, with a hazard twice higher for 3 or 11 mg/dl, compared to 5 mg/dl. In CKD patients, our results indicate that UA above 10 mg/dl is a strong risk marker for kidney failure and death and that low UA levels below 5 mg/dl are associated with death before kidney failure.
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PMCID: PMC9998636
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-023-30902-7