Hyperuricemia as a Predictor of Progression of Chronic Kidney Disease: A Matched Cohort Analysis

Background: The clinical significance of uric acid (UA) in patients with chronic kidney disease (CKD) has never been elucidated in detail. Objectives: The aim of this study was to elucidate the predictive value of hyperuricemia (HU) in relation to kidney disease progression in CKD patients. Methods: We reviewed data obtained from 201 CKD patients. Renal outcome was assessed by performing the Kaplan-Meier and Cox proportional hazard regression models. The renal outcomes of CKD patients with and without HU were compared by using a propensity score-matched cohort. Results: The results of a multivariate Cox regression analysis showed that HU (UA ≥ 7.1 mg/dL) (P = 0.001), diabetes mellitus (P = 0.003), and a high urine albumin-to-creatinine ratio (P = 0.0005) were significantly associated with a ≥50% eGFR decline or ESRD. The serum UA values were positively correlated with mean blood pressure (P = 0.007), visceral fat area (P = 0.0003), and maximum carotid intima-media thickness (P = 0.0003). The Kaplan-Meier analysis in the propensity score-matched cohort indicated that the renal survival rate of the group of CKD patients with HU was significantly lower than that of the group without HU (log rank, P < 0.0001), even after complete adjustment for the eGFR. Conclusion: The results of this study suggest that the serum UA value is a predictor of CKD progression.