Abstract: FR-PO0977
Hypouricemia and Improved Kidney Outcomes in Women: Implications for Sex-Specific Urate Metabolism
Session Information
- Women's Health and Kidney Diseases
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Women's Health and Kidney Diseases
- 2100 Women's Health and Kidney Diseases
Authors
- Aronoff, Benjamin William, Hackensack University Medical Center, Hackensack, New Jersey, United States
- Leiba, Adi, Assuta Ashdod Hospital, Ashdod, South District, Israel
- Lencovsky, Ori, Assuta Ashdod Hospital, Ashdod, South District, Israel
- Angel-Korman, Avital, Assuta Ashdod Hospital, Ashdod, South District, Israel
Background
Hypouricemia in men(sUA <3 mg/dL) has been associated with higher rates of kidney disease. In women, the relationship is more complex: some studies report U or J shaped associations between sUA and renal outcomes, whereas others suggest a linear association in which lower sUA levels are associated with more favorable renal risk. Given the inconclusive data on the renal effects of hypouricemia in women, and the relatively higher prevalence of low sUA in females, we evaluated a large population based cohort of women without CKD at baseline. We followed participants for the development of CKD (eGFR <60 ml/min/1.73 m2), the onset of moderately increased albuminuria (ACR>30mg/g) , and the occurrence of nephrolithiasis.
Methods
We conducted a retrospective, population based cohort study using electronic health records from Leumit Health Services between 2002 and 2024. Low sUA was defined as <3 mg/dL; women with at least one measurement in this range were classified as the low urate group. Women with elevated sUA (>6 mg/dL) were excluded. Additional exclusion criteria included malignancy, pregnancy, insulin use, and baseline CKD. Women aged 20–70 years were included. Cases were matched 1:2 with controls with normal sUA levels (3–6 mg/dL) according to age, ethnicity, socioeconomic status, and year of first electronic health record entry . Participants were followed from the index date to assess incident CKD, moderately increased albuminuria, and nephrolithiasis.
Results
The study cohort comprised 29,272 women with low sUA levels and 58,548 matched controls, with a mean follow up of approximately 9 years. Baseline characteristics were similar between the hypouricemic study group and the normouricemic controls . Incident CKD occurred in 0.67% of women with low sUA compared with 1.02% of controls with normal sUA levels (OR 0.66, 95% CI 0.56–0.78; p < 0.001). Moderately increased albuminuria was observed in 3.33% of women with low sUA and 3.51% of controls (odds ratio 0.95, 95% confidence interval 0.88–1.03). Low sUA was associated with higher rates of nephrolithiasis (3.2% vs. 2.5%; P<0.001).
Conclusion
In women, hypouricemia (sUA <3 mg/dL) is associated with a lower incidence of CKD compared with normouricemia, consistent with a linear relationship between uric acid levels and kidney function decline. These findings highlight the need to better define sex specific effects of uric acid on the kidney.