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  • Title: Association of uric acid with change in kidney function in healthy normotensive individuals.
    Author: Bellomo G, Venanzi S, Verdura C, Saronio P, Esposito A, Timio M.
    Journal: Am J Kidney Dis; 2010 Aug; 56(2):264-72. PubMed ID: 20385436.
    Abstract:
    BACKGROUND: Despite recent evidence, the role of uric acid as a causal factor in the pathogenesis and progression of kidney disease remains controversial, partly because of the inclusion in epidemiologic studies of patients with hypertension, diabetes, and/or proteinuria. STUDY DESIGN: Prospective observational cohort. SETTING & PARTICIPANTS: 900 healthy normotensive adult blood donors (153 women, 747 men) evaluated at baseline and after 5 years. PREDICTOR: Serum uric acid level. OUTCOMES: Decrease in estimated glomerular filtration rate (eGFR) >10 mL/min/1.73 m(2), computed using the Modification of Diet in Renal Disease (MDRD) Study equation, with secondary analyses examining similar decreases using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Cockcroft-Gault equations. RESULTS: During a median follow-up of 59 months, eGFR decreased from 97 +/- 16 to 88 +/- 14 mL/min/1.73 m(2). Higher serum uric acid levels were associated with a greater likelihood of eGFR decrease in both women and men (HR, 1.13 [95% CI, 1.04-1.39] per each 1-mg/dL increase in uric acid level); in multivariable analyses adjusting for age, sex, body mass index, blood glucose level, total cholesterol level, mean blood pressure, urine albumin-creatinine ratio, and serum triglyceride level, the association remained highly significant (HR, 1.28 [95% CI, 1.12-1.48]). Results were similar using different estimating equations and when the association was examined in sex-specific subgroups. LIMITATIONS: Analyses were based on a single baseline uric acid measurement. Women are underrepresented. CONCLUSIONS: In healthy normotensive individuals, serum uric acid level is an independent risk factor for decreased kidney function.
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