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Kidney Week

Abstract: FR-PO302

The Association Between Serum Uric Acid Levels and Incidence of Proteinuria: A Large-Scale Cohort Study in a Community-Based Population

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Ichikawa, Kazunobu, Yamagata University School of Medicine , Yamagata, Japan
  • Konta, Tsuneo, Yamagata University Graduate School of Medical Science, Yamagata, Japan
  • Fujimoto, Shouichi, University of Miyazaki, Miyazaki, Japan
  • Iseki, Kunitoshi, Nakamura Clinic, Urasoe, Japan
  • Moriyama, Toshiki, Osaka University Health Care Center, Toyonaka, Japan
  • Yamagata, Kunihiro, University of Tsukuba, Tsukuba, Japan
  • Tsuruya, Kazuhiko, Nara Medical University, Kashihara, Japan
  • Narita, Ichiei, Niigata University, Niigata, Japan
  • Kondo, Masahide, University of Tsukuba, Tsukuba, Japan
  • Shibagaki, Yugo, St Marianna University Hospital, Kawasaki, Japan
  • Kasahara, Masato, Institute for Clinical and Translational Science Nara Medical University Hospital, Kashihara, Japan
  • Asahi, Koichi, Iwate Medical University, Morioka, Iwate, Japan
  • Watanabe, Tsuyoshi, Fukushima Medical University School of Medicine, Fukushima City, Japan
Background

Hyperuricemia is associated with the development and the progression of renal disease. However, the threshold value of serum uric acid for the increased risk for proteinuria has not been determined. To clarify this point, we conducted a large-scale cohort study in a community-based population.

Methods

We used a nationwide database of 328,582 subjects without overt dipstick proteinuria at baseline (134,227 men, 194,355 women, aged 40–74) who participated in the annual “Specific Health Check and Guidance in Japan" check-up between 2008 and 2013, and were followed up for 6 years (median 3.0 years). We examined the association of serum uric acid levels at baseline with incident dipstick proteinuria (1+ or greater) in this population.

Results

During the follow-up period, 24,419 subjects (7.4%) newly developed dipstick proteinuria. In unadjusted Cox proportional hazard model, the hazard ratio (HR) for incident proteinuria was significantly increased both in men and women with high serum uric acid levels. In the adjusted model with possible confounders including age, renal function, smoking, alcohol consumption, and comorbidities, a similar significant trend was observed. The lowest HR was observed in men with serum uric acid 5.0-5.9 mg/dL and in women with 4.0-4.9 mg/dL, respectively. The significantly increased HRs for incident proteinuria was observed in the high range of serum uric acid in both men and women (> 8 mg/dL in men, > 5 mg/dL in women, respectively). The adjusted HRs of the conventional cut-off point of hyperuricemia (> 7.0 mg/dL) for incident proteinuria was 1.10 (95% confidence interval [CI] 1.05-1.15) in men, and 1.75 (95%CI 1.58-1.93) in women, respectively.

Conclusion

In this community-based population, the high serum uric acid level was an independent risk for incident proteinuria in both men and women and the threshold values of serum uric acid for incident proteinuria might be different for men and women.

Funding

  • Government Support - Non-U.S.