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Kidney Week

Abstract: FR-PO306

Longitudinal Serum Uric Acid Level and Long-Term Outcome in CKD by Trajectory Analysis from the Korean Cohort Study for Outcomes in Patients with CKD (KNOW-CKD)

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Kim, Yunmi, Inje University Busan Paik Hospital, Busan, Korea (the Republic of)
  • Koo, Ho seok, Inje university, Seoul, Korea (the Republic of)
  • Park, Yun Hee, Inje University Busan Paik Hospital, Busan, Korea (the Republic of)
  • Kim, Taehee, Inje University, Busan, Korea (the Republic of)
  • Kang, Sunwoo, Inje University, Busan, Korea (the Republic of)
  • Oh, Kook-Hwan, SNU College of Medicine, Seoul, Korea (the Republic of)
  • Ahn, Curie, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yeong Hoon, Inje University Medical School, Busan, Korea (the Republic of)
Background

Hyperuricemia is an independent risk factor for microalbuminuria and decline of renal function. Though, it has not been proven whether high serum uric acid on longitudinal basis predicts renal outcome in chronic kidney disease patients.

Methods

Among the 2,238 patients enrolled in the KoreaN cohort study for Outcomes in patients With Chronic Kidney Disease (KNOW-CKD), 1,039 patients whose serum uric acid were measured more than 3 times were included. Patients were classified into three groups according to repeatedly measured uric acid levels by trajectory analysis using K-means. We investigated baseline characteristics and outcomes of each group. Renal events were defined as either doubling of creatinine, estimated glomerular filtration rate halving, or end-stage renal disease. Composite events were defined as either death, non-fatal cardiovascular disease, or renal event.

Results

Mean uric acid level was 4.91 ± 1.36 mg/dL for low uric acid group, 6.29 ± 1.28 mg/dL for middle uric acid group, and 8.53 ± 1.26 mg/dL for high uric acid group. Men accounted for 42.4%, 64.1%, and 70.4% in low, middle, and high uric acid group, respectively. Proportion of patients with hypertension (99.0%) and diabetes mellitus (DM) (24.2%) were the greatest in high uric acid group. The risk of renal event was 2.01-fold higher in high uric acid group (95% CI 1.43-2.84, P < 0.001) than middle uric acid group when adjusted for age, sex, hypertension and DM, and 2.16-fold higher (95% CI 1.24-3.75, P = 0.006) when additionally adjusted for other relative factors. The risk of composite event of high uric acid group was also significantly higher compared with middle uric acid group after adjustment for age, sex, hypertension, and DM (HR 2.37, 95% CI 1.62-3.47), and after adjustment for additional factors (HR 2.99, 95% CI 1.60-5.68, P <0.001).

Conclusion

High uric acid level in longitudinal aspect was associated with adverse renal outcome and composite outcome in chronic kidney disease patients.

Funding

  • Government Support - Non-U.S.