Kidney Week

Abstract: SA-PO0575

Hyperuricemia and Kidney Prognosis in ADPKD: Insights from Attribute-Based Cross-Classification by Sex and Age

Session Information

• Cystic Kidney Diseases: Clinical Research
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidneys

• 1201 Genetic Diseases of the Kidneys: Monogenic Kidney Diseases

Authors

• Manabe, Shun, Tokyo Women's Medical University, Department of Nephrology, Shinjuku-ku, Tokyo, Japan

Shun Manabe, MD, PhD

• Kataoka, Hiroshi, Tokyo Women's Medical University, Department of Nephrology, Shinjuku-ku, Tokyo, Japan

Hiroshi Kataoka

• Mochizuki, Toshio, PKD Nephrology Clinic, Chuo-Ku, Tokyo, Japan

Toshio Mochizuki, MD, PhD

• Ushio, Yusuke, Tokyo Women's Medical University, Department of Nephrology, Shinjuku-ku, Tokyo, Japan

Yusuke Ushio, MD

• Seki, Momoko, Tokyo Women's Medical University, Department of Nephrology, Shinjuku-ku, Tokyo, Japan

Momoko Seki

• Tsuchiya, Ken, Tokyo Women's Medical University, Department of Nephrology, Shinjuku-ku, Tokyo, Japan

Ken Tsuchiya, MD, PhD

• Nitta, Kosaku, Tokyo Women's Medical University, Department of Nephrology, Shinjuku-ku, Tokyo, Japan

Kosaku Nitta

• Hoshino, Junichi, Tokyo Women's Medical University, Department of Nephrology, Shinjuku-ku, Tokyo, Japan

Junichi Hoshino, MD, PhD, MPH

Background

Hyperuricemia may contribute to disease progression in ADPKD, but its prognostic impact remains unclear, especially across sex and age groups. We investigated its influence on renal outcomes using an attribute-based cross-classification by sex and age.

Methods

We analyzed 553 ADPKD patients not undergoing renal replacement therapy (median age: 43 years; eGFR: 55.9 mL/min/1.73 m²; total kidney volume: 1335.4 mL). Hyperuricemia was defined as serum urate ≥7.0 mg/dL or use of urate-lowering therapy. Patients were cross-classified by sex (men/women) and age (<50/≥50 years). The renal outcome—≥30% eGFR decline or initiation of renal replacement therapy—was assessed using Cox regression. Mean follow-up was 6.9 years; 266 patients experienced renal events.

Results

Hyperuricemia was not associated with worse renal prognosis in the overall cohort (HR=1.34, P=0.120).
When examining the interaction between hyperuricemia and age 50 years or older according to sex, a significant difference was observed in men (interaction P=0.004) but not in women (interaction P=0.450). Cross-classification revealed a strong association between hyperuricemia and poor outcomes in women aged <50 years (HR=3.51, P=0.034) and in men aged <50 years (HR=2.06, P=0.026). No significant associations were observed in either sex ≥50 years.

Conclusion

Hyperuricemia is an important modifiable risk factor for renal progression in ADPKD, particularly in younger patients. The association was strongest in patients under 50 years of age, while no significant impact was observed in older patients. The attribute-based cross-classification analysis provides novel insights into individualized risk stratification and highlights subgroups at higher risk.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025ax3cdstr