Kidney Week

Abstract: FR-PO0290

Uric Acid Testing in US Veterans with CKD: Associations with Kidney Function, Gout, and Patient Characteristics

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

• Yamada, Masaaki, Iowa City VA Medical Center, Iowa City, Iowa, United States

Masaaki Yamada, MD, FASN

• Good, Mary K., Iowa City VA Medical Center, Iowa City, Iowa, United States

Mary K. Good, PhD

• Gao, Yubo, University of Iowa Health Care, Iowa City, Iowa, United States

Yubo Gao, PhD

• Gaffo, Angelo L., University of Alabama at Birmingham Health System, Birmingham, Alabama, United States

Angelo L. Gaffo, MD

• Swee, Melissa L., Iowa City VA Medical Center, Iowa City, Iowa, United States

Melissa L. Swee, MD, MS, FASN

• Jalal, Diana I., Iowa City VA Medical Center, Iowa City, Iowa, United States

Diana I. Jalal, MD, FASN

• Sarrazin, Mary Vaughan, University of Iowa Health Care, Iowa City, Iowa, United States

Mary Vaughan Sarrazin, PhD

Background

Gout is a common inflammatory arthritis caused by hyperuricemia. Because reduced kidney function impairs urate clearance, gout frequently co-occurs with chronic kidney disease (CKD) and has been linked to incident CKD and faster CKD progression. However, the clinical value of routine urate monitoring in CKD remains controversial, and little is known about uric acid testing patterns and racial differences among Veterans.

Methods

We performed a retrospective cohort study using Veterans Affairs data. CKD was defined by estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² (≥90 days apart); eGFR groups were 45–59, 30–44, and 15–29, excluding eGFR <15. The outcome was ≥1 serum uric acid test. We used multivariable logistic regression to estimate odds ratios for testing, adjusting for demographics and comorbidities.

Results

We identified 319,387 Veterans with CKD; 47,314 (15%) had uric acid testing and 272,073 (85%) did not. The mean age was 62.8 years, and the cohort was predominantly male (93%). Racial composition was 73% White, 23% Black, 1% Pacific Islander, and 3% other race categories. Uric acid testing increased with worsening CKD stage (overall 15%; 3A, 14%; 3B, 17%; 4, 18%). In adjusted analyses (Table 1), uric acid testing was more common among those with advanced CKD, younger age, Black race, and higher comorbidity burden, with the strongest association observed for gout. In contrast, testing was less common in older adults and in patients with diabetes.

Conclusion

Uric acid testing was more common among Veterans with advanced CKD and higher comorbidity burden, with gout showing the strongest association. These findings underscore the importance of accurately identifying prevalent gout and proactively screening patients at risk for hyperuricemia, and addressing variation in testing by age and diabetes status.

Funding

• Veterans Affairs Support