Abstract: FR-PO0295
Association of Serum Uric Acid with Early Albuminuria in Adults Without Diabetes or CKD: An NHANES Analysis
Session Information
- CKD: Omics, Systemic Stressors, and Targeted Pharmacotherapy
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Mace de Lepinay, Beatrice, NYC Health and Hospitals Elmhurst, Elmhurst, New York, United States
- Margalioth, Jonathan, NYC Health and Hospitals Elmhurst, Elmhurst, New York, United States
- Mc Daid, Alexander Andrew, NYC Health and Hospitals Elmhurst, Elmhurst, New York, United States
- Stern, Aaron S., NYC Health and Hospitals Elmhurst, Elmhurst, New York, United States
Background
Elevated serum uric acid has been associated with chronic kidney disease (CKD) progression and albuminuria in high-risk populations, but its relationship with early kidney injury in adults without diabetes or CKD remains unclear. We evaluated the association between serum uric acid and albuminuria in a nationally representative sample of U.S. adults without overt kidney disease.
Methods
We conducted a cross-sectional analysis of adults from the National Health and Nutrition Examination Survey (NHANES) 2007–2018. Individuals with CKD (eGFR <60 mL/min/1.73 m2) or diabetes were excluded. Serum uric acid was analyzed continuously and by quartiles. The primary outcome was albuminuria (defined as UACR ≥30 mg/g). Survey-weighted logistic regression models were used to estimate the association between serum uric acid and albuminuria, adjusting for age, sex, race/ethnicity, body mass index, and hypertension. Because hypertension may represent both a contributor to and manifestation of kidney injury, hypertensive individuals were not excluded; instead, stratified analyses were conducted by hypertension status. Sensitivity analyses excluded individuals with severe obesity (BMI ≥40 kg/m2) and gout. Secondary analyses evaluated log-transformed UACR as a continuous outcome.
Results
Higher serum uric acid was independently associated with albuminuria, with each 1 mg/dL increase associated with 19% higher odds (OR 1.19, 95% CI 1.12–1.29, p<0.001). This association remained significant after excluding individuals with severe obesity and gout and after adjustment for hypertension. In stratified analyses, the association remained significant in both normotensive and hypertensive individuals and was slightly stronger among participants without hypertension (OR 1.22, 95% CI 1.12–1.32 vs. OR 1.16, 95% CI 1.07–1.25). In secondary analyses evaluating continuous log-transformed UACR, higher serum uric acid levels remained independently associated with increased urinary albumin excretion (β = 0.020, p = 0.002), supporting a graded relationship between uric acid and early kidney injury.
Conclusion
Elevated serum uric acid was independently associated with early albuminuria in adults without diabetes or CKD. These findings suggest that uric acid may be linked to early renal injury prior to overt CKD and may represent a marker of subclinical kidney dysfunction.