Background: To what extent uric acid (UA) levels and/or metabolic syndrome (Mets) contribute to the onset of chronic kidney disease (CKD) is largely unknown. The present study explores how these two factors have an association with the new incidence of CKD. Methods: Study design is a cohort study. A total of 14,485 participants were eligible for the cross-sectional analysis on UA levels and the prevalence of Mets. Among those individuals, 8,223 participants without CKD and 4,839 without Mets were eligible for the longitudinal analysis of the new incidence of CKD. Parameters monitored were body mass index, systolic and diastolic blood pressure, serum creatinine concentration, estimated glolerular filtration rate, lipid profiles, plasma glucose, HbA1c. The primary predictor was the level of UA and Mets to explain the newly-developed CKD. The observation period was 4 years. Results: In a cross-sectional analysis, higher UA levels were associated with the greater prevalence of Mets. In addition, UA levels were associated with the numbers of the Mets constituents in both genders. In a longitudinal analysis, higher UA levels were associated with the greater rate of CKD and the greater incidence of Mets. In addition, the incidence of CKD at year 4 was influenced by the presence of hyperuricemia, but not by that of the Mets. The odd ratio (OR) to predict the CKD incidence was 1.42 (95% confidence intervals (CI), 0.52 to 3.78) in the presence of Mets alone, 2.10 (95% CI, 1.36 to 3.23) in the presence of hyperuricemia alone, and 3.56 (95% CI, 1.55 to 8.21) in the presence of both. Conclusion: Hyperuricemia has a greater association with the incidence of CKD than Mets does. Hyperuricemia complicated by Mets is additionally detrimental.
References
[1]
Syrjanen, J., Mustonen, J. and Pasternack, A. (2000) Hypertriglyceridaemia and Hyperuricaemia Are Risk Factors for Progression of IgA Nephropathy. Nephrology Dialysis Transplantation, 15, 34-42. http://dx.doi.org/10.1093/ndt/15.1.34
[2]
Taniguchi, Y., Hayashi, T., Tsumura, K., Endo, G., Fujii, S. and Okada, K. (2001) Serum Uric Acid and the Risk for Hypertension and Type 2 Diabetes in Japanese Men: The Osaka Health Survey. Journal of Hypertension, 19, 1209-1215. http://dx.doi.org/10.1097/00004872-200107000-00005
[3]
Bo, S., Cavallo-Perin, P., Gentile, L., Repetti, E. and Pagano, G. (2001) Hypouricemia and Hyperuricemia in Type 2 Diabetes: Two Different Phenotypes. European Journal of Clinical Investigation, 31, 318-321. http://dx.doi.org/10.1046/j.1365-2362.2001.00812.x
[4]
Fessel, W.J. (1979) Renal Outcomes of Gout and Hyperuricemia. The American Journal of Medicine, 67, 74-82. http://dx.doi.org/10.1016/0002-9343(79)90076-7
[5]
Yu, T.F. and Berger, L. (1982) Impaired Renal Function Gout: Its Association with Hypertensive Vascular Disease and Intrinsic Renal Disease. The American Journal of Medicine, 72, 95-100.
[6]
Iseki, K., Oshiro, S., Tozawa, M., Iseki, C., Ikemiya, Y. and Takishita, S. (2001) Significance of Hyperuricemia on the Early Detection of Renal Failure in a Cohort of Screened Subjects. Hypertension Research, 24, 691-697. http://dx.doi.org/10.1291/hypres.24.691
[7]
Iseki, K., Ikemiya, Y., Inoue, T., Iseki, C., Kinjo, K. and Takishita, S. (2004) Significance of Hyperuricemia as a Risk Factor for Developing ESRD in a Screened Cohort. American Journal of Kidney Diseases, 44, 642-650. http://dx.doi.org/10.1016/S0272-6386(04)00934-5
[8]
Johnson, R.J., Segal, M.S., Srinivas, T., Ejaz, A., Mu, W., Roncal, C., Sánchez-Lozada, L.G., Gersch, M., Rodriguez-Iturbe, B., Kang, D.H. and Acosta, J.H. (2005) Essential Hypertension, Progressive Renal Disease, and Uric Acid: A Pathogenetic Link? Journal of the American Society of Nephrology, 16, 1909-1919. http://dx.doi.org/10.1681/ASN.2005010063
[9]
Kanellis, J., Feig, D.I. and Johnson, R.J. (2004) Does Asymptomatic Hyperuricaemia Contribute to the Development of Renal and Cardiovascular Disease? An Old Controversy Renewed. Nephrology, 9, 394-399. http://dx.doi.org/10.1111/j.1440-1797.2004.00336.x
[10]
Kuriyama, S., Maruyama, Y., Nishio, S., Takahashi, Y., Kidoguchi, S., Kobayashi, C., Takahashi, D., Sugano, N., Hosoya, T. and Yokoo, T. (2015) Serum Uric Acid and the Incidence of CKD and Hypertension. Clinical and Experimental Nephrology, 19, 1127-1134.
[11]
Kaur, J. (2014) A Comprehensive Review on Metabolic Syndrome. Cardiology Research and Practice, 2014, Article ID: 943162.
[12]
KDIGO (2012) Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Chapter 1: Definition and Classification of Chronic Kidney Disease. Kidney International, 3, 5-8.
[13]
Matsuo, S., Imai, E., Horio, M., Yasuda, Y., Tomita, K., Nitta, K., Yamagata, K., Tomino, Y., Yokoyama, H. and Hishida, A. (2009) On Behalf of the Collaborators Developing the Japanese Equation for Estimated GFR. Revised Equations for Estimated GFR from Serum Creatinine in Japan. American Journal of Kidney Diseases, 53, 982-992. http://dx.doi.org/10.1053/j.ajkd.2008.12.034
[14]
Messerli, F.H., Frohlich, E.D., Dreslinski, G.R., Suarez, D.H. and Aristimuno, G.G. (1980) Serum Uric Acid in Essential Hypertension: An Indicator of Renal Vascular involvement. Annals of Internal Medicine, 93, 817-821. http://dx.doi.org/10.7326/0003-4819-93-6-817
[15]
Feig, D.I., Kang, D.H. and Johnson, R.J. (2008) Uric Acid and Cardiovascular Risk. The New England Journal of Medicine, 359, 1811-1821. http://dx.doi.org/10.1056/NEJMra0800885
[16]
Tamba, S., Nishizawa, H., Funahashi, T., Okauchi, Y., Ogawa, T., Noguchi, M., Fujita, K., Ryo, M., Kihara, S., Iwahashi, H., Yamagata, K., Nakamura, T., Shimomura, I. and Matsuzawa, Y. (2008) Relationship between the Serum Uric Acid Level, Visceral Fat Accumulation and Serum Adiponectin Concentration in Japanese Men. Internal Medicine, 47, 1175-1180. http://dx.doi.org/10.2169/internalmedicine.47.0603
[17]
Lin, B., Shao, L., Luo, Q., Ou-yang, L., Zhou, F., Du, B., He, Q., Wu, J., Xu, N. and Chen, J. (2014) Prevalence of Chronic Kidney Disease and Its Association with Metabolic Diseases: A Cross-Sectional Survey in Zhejiang Province, Eastern China. BMC Nephrology, 15, 36. http://dx.doi.org/10.1186/1471-2369-15-36
[18]
Nashar, K. and Egan, B.M. (2014) Relationship between Chronic Kidney Disease and Metabolic Syndrome: Current Perspectives. Diabetes, Metabolic Syndrome and Obesity, 7, 421-435. http://dx.doi.org/10.2147/DMSO.S45183
[19]
Choi, H.K. and Ford, E.S. (2007) Prevalence of the Metabolic Syndrome in Individuals with Hyperuricemia. American Journal of Medicine, 120, 442-447. http://dx.doi.org/10.1016/j.amjmed.2006.06.040
[20]
Hjortnaes, J., Algra, A., Olijhoek, J., Huisman, M., Jacobs, J., van der Graaf, Y. and Visseren, F. (2007) Serum Uric Acid Levels and Risk for Vascular Diseases in Patients with Metabolic Syndrome. The Journal of Rheumatology, 34, 1882-1887.
[21]
See, L.C., Kuo, C.F., Chuang, F.H., Shen, Y.M., Ko, Y.S., Chen, Y.M. and Yu, K.H. (2011) Hyperuricemia and Metabolic Syndrome: Associations with Chronic Kidney Disease. Clinical Rheumatology, 30, 323-330. http://dx.doi.org/10.1007/s10067-010-1461-z
[22]
Go, A.S., Chertow, G.M., Fan, D., McCulloch, C.E. and Hsu, C.Y. (2004) Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and Hospitalization. The New England Journal of Medicine, 351, 1296-1505. http://dx.doi.org/10.1056/NEJMoa041031
[23]
Werner, D.E., Tighiouart, H., Elsayed, E.F., Griffith, J.L., Salem, D.N. and Levey, A.S. (2008) Uric Acid and Incident Kidney Disease in the Community. Journal of the American Society of Nephrology, 19, 1204-1211. http://dx.doi.org/10.1681/ASN.2007101075
[24]
Chonchol, M., Shlipak, M.G., Katz, R., Sarnak, M.J., Newman, A.B., Siscovick, D.S., Kestenbaum, B., Carney, J.K. and Fried, L.F. (2007) Relationship of Uric Acid with Progression of Kidney Disease. American Journal of Kidney Diseases, 50, 239-247. http://dx.doi.org/10.1053/j.ajkd.2007.05.013
[25]
Cannon, P.J., Stason, W.B., Demartini, F.E., Sommers, S.C. and Laragh, J.H. (1996) Hyperuricemia in Primary and Renal Hypertension. The New England Journal of Medicine, 275, 457-464. http://dx.doi.org/10.1056/NEJM196609012750902
[26]
Nakagawa, T., Tuttle, K.R., Short, R.A. and Johnson, R.J. (2005) Fructose-Induced Hyperuricemia as a Causal Mechanism for the Epidemic of the Metabolic Syndrome. Nature Clinical Practice Nephrology, 1, 80-86. http://dx.doi.org/10.1038/ncpneph0019
[27]
Masuo, K., Kawaguchi, H., Mikami, H., Ogihara, T. and Tuck, M.L. (2003) Serum Uric Acid and Plasma Norepinephrine Concentrations Predict Subsequent Weight Gain and Blood Pressure Elevation. Hypertension, 42, 474-480. http://dx.doi.org/10.1161/01.HYP.0000091371.53502.D3
[28]
Tomita, M., Mizuno, S., Yamanaka, H., Hosoda, Y., Sakuma, K., Matsuoka, Y., Okada, M., Yamaguchi, M., Yosida, H., Morisawa, H. and Murayama, T. (2000) Does Hyperuricemia Affect Mortality? A Prospective Cohort Study of Japanese Male Workers. Journal of Epidemiology, 10, 403-409. http://dx.doi.org/10.2188/jea.10.403
