Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study.
<h4>Background</h4>Hyperuricemia is highly prevalent in chronic kidney disease (CKD) patients, but the evidence for a relationship between uric acid (UA) and clinical outcomes in CKD patients is limited and inconsistent. We hypothesized that UA has a different impact on clinical outcomes...
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0249240&type=printable |
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| author | Kimio Watanabe Masaaki Nakayama Tae Yamamoto Gen Yamada Hiroshi Sato Mariko Miyazaki Sadayoshi Ito |
| author_facet | Kimio Watanabe Masaaki Nakayama Tae Yamamoto Gen Yamada Hiroshi Sato Mariko Miyazaki Sadayoshi Ito |
| author_sort | Kimio Watanabe |
| collection | DOAJ |
| description | <h4>Background</h4>Hyperuricemia is highly prevalent in chronic kidney disease (CKD) patients, but the evidence for a relationship between uric acid (UA) and clinical outcomes in CKD patients is limited and inconsistent. We hypothesized that UA has a different impact on clinical outcomes according to the underlying disease causing CKD.<h4>Methods</h4>This study prospectively investigated the associations between UA and renal and non-renal outcomes according to the underlying disease causing CKD in 2,797 Japanese patients under the care of nephrologists. The patients were categorized into four groups: primary renal disease (n = 1306), hypertensive nephropathy (n = 467), diabetic nephropathy (n = 275), and other nephropathy (n = 749). The renal outcome was defined as end-stage renal disease (ESRD), and the non-renal outcome was defined as a composite endpoint of cardiovascular events (CVEs) and all-cause mortality.<h4>Results</h4>During a median 4.8-year follow-up, 359 (12.8%) patients reached the renal outcome, and 260 (9.3%) reached the non-renal outcome. In the all-patient analysis, hyperuricemia was not associated with the risks for renal and non-renal outcomes, but in primary renal disease (PRD) and hypertensive renal disease (HTN) patients, hyperuricemia was significantly associated with non-renal outcomes. Per 1 mg/dl higher UA level, multivariable adjusted hazard ratio was 1.248 (95% CI: 1.003 to 1.553) for PRD, and 1.250 (1.035 to 1.510) for HTN. Allopurinol did not reduce the risks for renal and non-renal outcomes, both in all patients and in the subgroup analysis.<h4>Conclusions</h4>The effect of hyperuricemia on clinical outcomes in CKD patients varies according to the underlying disease causing CKD. Hyperuricemia is an independent risk factor for non-renal outcomes in primary renal disease and hypertensive renal disease patients. Allopurinol did not decrease the risks for renal and non-renal outcomes. |
| format | Article |
| id | doaj-art-2633d03062a348a58fc9c181bdb4aac2 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-2633d03062a348a58fc9c181bdb4aac22025-08-20T02:55:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01163e024924010.1371/journal.pone.0249240Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study.Kimio WatanabeMasaaki NakayamaTae YamamotoGen YamadaHiroshi SatoMariko MiyazakiSadayoshi Ito<h4>Background</h4>Hyperuricemia is highly prevalent in chronic kidney disease (CKD) patients, but the evidence for a relationship between uric acid (UA) and clinical outcomes in CKD patients is limited and inconsistent. We hypothesized that UA has a different impact on clinical outcomes according to the underlying disease causing CKD.<h4>Methods</h4>This study prospectively investigated the associations between UA and renal and non-renal outcomes according to the underlying disease causing CKD in 2,797 Japanese patients under the care of nephrologists. The patients were categorized into four groups: primary renal disease (n = 1306), hypertensive nephropathy (n = 467), diabetic nephropathy (n = 275), and other nephropathy (n = 749). The renal outcome was defined as end-stage renal disease (ESRD), and the non-renal outcome was defined as a composite endpoint of cardiovascular events (CVEs) and all-cause mortality.<h4>Results</h4>During a median 4.8-year follow-up, 359 (12.8%) patients reached the renal outcome, and 260 (9.3%) reached the non-renal outcome. In the all-patient analysis, hyperuricemia was not associated with the risks for renal and non-renal outcomes, but in primary renal disease (PRD) and hypertensive renal disease (HTN) patients, hyperuricemia was significantly associated with non-renal outcomes. Per 1 mg/dl higher UA level, multivariable adjusted hazard ratio was 1.248 (95% CI: 1.003 to 1.553) for PRD, and 1.250 (1.035 to 1.510) for HTN. Allopurinol did not reduce the risks for renal and non-renal outcomes, both in all patients and in the subgroup analysis.<h4>Conclusions</h4>The effect of hyperuricemia on clinical outcomes in CKD patients varies according to the underlying disease causing CKD. Hyperuricemia is an independent risk factor for non-renal outcomes in primary renal disease and hypertensive renal disease patients. Allopurinol did not decrease the risks for renal and non-renal outcomes.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0249240&type=printable |
| spellingShingle | Kimio Watanabe Masaaki Nakayama Tae Yamamoto Gen Yamada Hiroshi Sato Mariko Miyazaki Sadayoshi Ito Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study. PLoS ONE |
| title | Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study. |
| title_full | Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study. |
| title_fullStr | Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study. |
| title_full_unstemmed | Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study. |
| title_short | Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study. |
| title_sort | different clinical impact of hyperuricemia according to etiologies of chronic kidney disease gonryo study |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0249240&type=printable |
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