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Abstract: FR-PO920

Serum Uric Acid Trajectories and CKD Progression in the African American Study of Kidney Disease in Hypertension (AASK)

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Cho, Sungkweon, Ajou University School of Medicine and Graduate School of Medicine, Suwon, Gyeonggi-do, Korea (the Republic of)
  • Kopp, Jeffrey B., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States

Serum uric acid levels increase with progressive kidney disease, due to retention of uric acid resulting from a reduced glomerular filtration rate (eGFR). Chronic elevations in circulating and tissue levels of uric acid may contribute to progression of chronic kidney disease, although this remains controversial.


We used data from the African American Study of Kidney Disease in Hypertension (AASK) to examine the hypothesis that subjects whose serum urate levels declined during the study period would manifest less composite end-stage kidney disease (ESKD) event. The composite ESKD outcome was defined as 50% decline from baseline eGFR, eGFR ≤15 mL/min/1.73 m2, self-reported initiation of chronic dialysis, or kidney transplantation. To estimate the trajectory, the group-based trajectory modeling of the uric acid level change was done. We classified into 5 groups ; high-stable group, the high-increasing group, the extreme high-stable group, normo-increasing group, and high-decreasing group. Cox proportional hazards model was used to estimate whether the different group membership would predict the composite ESKD outcomes.


We found that compared with subjects in the normal-increasing uric acid group (i.e., those who had the lowest overall serum uric acid levels), three groups had higher incidence of the composite ESKD event: the high-stable uric acid group, HR = 2.28, p = 0.012, the high-increasing uric acid group, HR = 1.95, p = 0.042, and the extremely high-stable uric acid group, HR = 3.21, p < 0.001. Further, the extremely high-stable group had a higher composite ESKD incidence, compared with the high-decreasing group, HR = 1.98, p = 0.046.


Uric acid trajectories are associated with ESKD incidence. In particular, subjects whose uric acid levels decreased over time had a better composite ESKD event than other groups.


  • Government Support – Non-U.S.