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Kidney Week

Abstract: TH-OR045

Uric Acid, Kidney Function, and Cardiovascular Risk among Children with CKD

Session Information

Category: Pediatric Nephrology

  • 1600 Pediatric Nephrology

Authors

  • Hashmat, Shireen, University of Chicago, Chicago, Illinois, United States
  • Jiang, Shuai, Johns Hopkins University, Baltimore, Maryland, United States
  • Ng, Derek, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Warady, Bradley A., Children's Mercy Kansas City, Kansas City, Missouri, United States
  • Pan, Cynthia G., Children's Corporate Center, Milwaukee, Wisconsin, United States
Background

Previous studies have shown that high uric acid (UA) is associated with cardiovascular risk factors in adults with and without chronic kidney disease (CKD), but the relationships in children with CKD are not well characterized. We used longitudinal data from the Chronic Kidney Disease in Children (CKiD) cohort study to investigate the relationships between UA, kidney function and cardiovascular outcomes.

Methods

The primary exposure was time-varying UA measured at annual visits. The primary outcomes were blood pressure (BP; clinical and ambulatory) and markers of cardiometabolic health (ie, lipids). Multivariate linear mixed effects models described UA z-scores (scaled within the CKiD population) with BP and lipid outcomes.

Results

A total of 718 participants (mean age= 13, 60% male and 29% with a glomerular-based CKD diagnosis) with at least 1 UA measurement were included in the analysis. At baseline, 47% had a high UA based on age- and gender-specific cutpoints. The figure (below) demonstrates that the UA increased with age, as well as decreasing eGFR even when adjusted for age. Whereas UA was associated with higher clinical and ambulatory BP, the differences were not significant. In models adjusted for age, gender, race, BMI, CKD diagnosis and eGFR, participants with one SD higher UA had significantly lower HDL (47 vs 50 mg/dL), higher LDL (93 vs 89 mg/dL) and higher total triglycerides (116 vs 110 mg/dL) at baseline compared to those with the average UA. Higher UA was also significantly associated with slower increase in HDL with time (p= 0.002). UA was not associated with longitudinal changes in clinical or ambulatory BP measurements.

Conclusion

There is a strong relationship between eGFR and UA in children with CKD. Higher UA is associated with a more severe lipid profile at baseline and over time, but is not independently associated with hypertension.

Funding

  • NIDDK Support