Association of uric acid in serum and urine with subclinical renal damage: Hanzhong Adolescent Hypertension Study

PLoS One. 2019 Nov 15;14(11):e0224680. doi: 10.1371/journal.pone.0224680. eCollection 2019.

Abstract

Background and objectives: The aim of the study was to examine the associations of uric acid (UA) in blood and urine with subclinical renal damage (SRD) and its progression in a Chinese cohort.

Methods: 1) 2342 participants from our previously established cohort who were followed up in 2017 were included. Cross-sectional analysis was used to examine the relationships between serum and urinary UA and the risk of SRD. 2) A total of 266 participants were recruited from the same cohort in 2013, and followed up in 2017. Longitudinal analysis was used to determine the relationships of serum and urinary UA with progression of SRD, which was defined as urinary albumin-to-creatinine ratio (uACR) progression or estimated glomerular filtration rate (eGFR) decline.

Results: In cross-sectional analysis, higher levels of uACR were associated with higher levels of serum uric acid (SUA) and urinary uric acid/creatinine ratio (uUA/Cre). Lower eGFR was associated with higher levels of SUA and fractional excretion of uric acid (FEUA) but lower uUA/Cre levels in all subjects. In addition, the multivariate-adjusted odds ratios for SRD compared with non-SRD were 3.574 (2.255-5.664) for uUA/Cre. Increasing uUA/Cre levels were associated with higher risk of SRD. In longitudinal analysis, 4-year changes of uUA/Cre and SUA were significantly associated with eGFR decline.

Conclusions: This study suggested that urinary UA excretion was significantly associated with the risk of SRD in Chinese adults. Furthermore, 4-year changes of serum and urinary UA were associated with SRD progression. These findings suggest that UA, especially urinary UA, may be used as a simple, noninvasive marker for early detection of decreased renal function in otherwise healthy subjects.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • Biomarkers / urine
  • Child
  • China / epidemiology
  • Cohort Studies
  • Creatinine / blood
  • Creatinine / urine
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Hypertension / blood
  • Hypertension / complications*
  • Hypertension / epidemiology
  • Hypertension / urine
  • Incidence
  • Kidney / pathology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / etiology
  • Renal Insufficiency, Chronic / urine
  • Risk Factors
  • Serum Albumin, Human / urine
  • Uric Acid / blood
  • Uric Acid / urine*
  • Young Adult

Substances

  • Biomarkers
  • Uric Acid
  • Creatinine
  • Serum Albumin, Human

Grants and funding

This work was supported by the National Natural Science Foundation of China No. 81600327 (Y.W.), No. 81870319, 81570381 (J.-J.M.) and No. 81700368 (C.C.), the Grants from China Postdoctoral Science Foundation No. 2018T111075 and 2018M631177 (Y.W.), Fundamental Research Funds for the Central Universities No. xjj2018103 (Y.W.), the Special Financial Grant from the Shaanxi Postdoctoral Science Foundation (Y.W.), the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University No. XJTU1AF-CRF-2017-021 (Y.W.), Grants 2016YFC1300104 and 2017YFC1307604 (J.-J.M.) from the Major Chronic Non-communicable Disease Prevention and Control Research Key Project of the Ministry of Science and Technology of China, and Grant 2017ZDXM-SF-107 (J.-J.M.) from the Key Research Project of Shaanxi Province. The funders had no role in study design, data collection and analysis, or preparation of the manuscript.