Relationship of Serum Uric Acid with Kidney Function Decline Mediated by Systemic Arterial Stiffness: A Retrospective Cohort Study in Japan
Hyperuricemia is associated with kidney function decline (KFD), although whether hyperuricemia directly causes nephrotoxicity or is indirectly mediated by systemic arterial stiffening remains unclear. We examined the detailed relationship of serum uric acid (SUA) with KFD and potential mediation by...
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MDPI AG
2024-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/2/195 |
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| author | Daiji Nagayama Yasuhiro Watanabe Kentaro Fujishiro Kenji Suzuki Kohji Shirai Atsuhito Saiki |
| author_facet | Daiji Nagayama Yasuhiro Watanabe Kentaro Fujishiro Kenji Suzuki Kohji Shirai Atsuhito Saiki |
| author_sort | Daiji Nagayama |
| collection | DOAJ |
| description | Hyperuricemia is associated with kidney function decline (KFD), although whether hyperuricemia directly causes nephrotoxicity or is indirectly mediated by systemic arterial stiffening remains unclear. We examined the detailed relationship of serum uric acid (SUA) with KFD and potential mediation by arterial stiffness. Study population was 27,648 urban residents with an estimated glomerular filtration rate (eGFR) of ≥60 mL/min/1.73 m<sup>2</sup> at baseline, and they participated in a median of three consecutive annual health examinations. Arterial stiffness was assessed using cardio-ankle vascular index (CAVI). KFD was defined as a decrease in eGFR to below 60. Multivariate analysis showed an association between baseline SUA and CAVI independent of eGFR. During the study period, 6.6% of participants developed KFD. Stratified analysis revealed a linear relationship between the contribution of CAVI or SUA and KFD. ROC analysis determined a cutoff CAVI of 8.0 (males) or 7.9 (females) and a cutoff SUA of 6.3 (males) or 4.5 mg/dL (females) for predicting KFD. The linkage between SUA and CAVI was associated with a greater increase in the hazard ratio for KFD with an increase in SUA. CAVI showed the mediating effect on the relationship of SUA with KFD after an adjustment for confounders. SUA was associated positively with CAVI-mediated KFD. Further studies should verify whether intensive SUA-lowering treatment prevents KFD via improving vascular function. |
| first_indexed | 2024-03-08T10:59:56Z |
| format | Article |
| id | doaj.art-37008cfe10844236921e88449a841040 |
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| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-08T10:59:56Z |
| publishDate | 2024-01-01 |
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| series | Diagnostics |
| spelling | doaj.art-37008cfe10844236921e88449a8410402024-01-26T16:01:48ZengMDPI AGDiagnostics2075-44182024-01-0114219510.3390/diagnostics14020195Relationship of Serum Uric Acid with Kidney Function Decline Mediated by Systemic Arterial Stiffness: A Retrospective Cohort Study in JapanDaiji Nagayama0Yasuhiro Watanabe1Kentaro Fujishiro2Kenji Suzuki3Kohji Shirai4Atsuhito Saiki5Department of Internal Medicine, Nagayama Clinic, Oyama-City 323-0032, Tochigi, JapanCenter of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Sakura-City 285-0841, Chiba, JapanJapan Health Promotion Foundation, Shibuya-ku 150-0013, Tokyo, JapanJapan Health Promotion Foundation, Shibuya-ku 150-0013, Tokyo, JapanDepartment of Internal Medicine, Mihama Hospital, Chiba-City 261-0013, Chiba, JapanCenter of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, Sakura-City 285-0841, Chiba, JapanHyperuricemia is associated with kidney function decline (KFD), although whether hyperuricemia directly causes nephrotoxicity or is indirectly mediated by systemic arterial stiffening remains unclear. We examined the detailed relationship of serum uric acid (SUA) with KFD and potential mediation by arterial stiffness. Study population was 27,648 urban residents with an estimated glomerular filtration rate (eGFR) of ≥60 mL/min/1.73 m<sup>2</sup> at baseline, and they participated in a median of three consecutive annual health examinations. Arterial stiffness was assessed using cardio-ankle vascular index (CAVI). KFD was defined as a decrease in eGFR to below 60. Multivariate analysis showed an association between baseline SUA and CAVI independent of eGFR. During the study period, 6.6% of participants developed KFD. Stratified analysis revealed a linear relationship between the contribution of CAVI or SUA and KFD. ROC analysis determined a cutoff CAVI of 8.0 (males) or 7.9 (females) and a cutoff SUA of 6.3 (males) or 4.5 mg/dL (females) for predicting KFD. The linkage between SUA and CAVI was associated with a greater increase in the hazard ratio for KFD with an increase in SUA. CAVI showed the mediating effect on the relationship of SUA with KFD after an adjustment for confounders. SUA was associated positively with CAVI-mediated KFD. Further studies should verify whether intensive SUA-lowering treatment prevents KFD via improving vascular function.https://www.mdpi.com/2075-4418/14/2/195serum uric acidkidney function declinearterial stiffnesscardio-ankle vascular index |
| spellingShingle | Daiji Nagayama Yasuhiro Watanabe Kentaro Fujishiro Kenji Suzuki Kohji Shirai Atsuhito Saiki Relationship of Serum Uric Acid with Kidney Function Decline Mediated by Systemic Arterial Stiffness: A Retrospective Cohort Study in Japan Diagnostics serum uric acid kidney function decline arterial stiffness cardio-ankle vascular index |
| title | Relationship of Serum Uric Acid with Kidney Function Decline Mediated by Systemic Arterial Stiffness: A Retrospective Cohort Study in Japan |
| title_full | Relationship of Serum Uric Acid with Kidney Function Decline Mediated by Systemic Arterial Stiffness: A Retrospective Cohort Study in Japan |
| title_fullStr | Relationship of Serum Uric Acid with Kidney Function Decline Mediated by Systemic Arterial Stiffness: A Retrospective Cohort Study in Japan |
| title_full_unstemmed | Relationship of Serum Uric Acid with Kidney Function Decline Mediated by Systemic Arterial Stiffness: A Retrospective Cohort Study in Japan |
| title_short | Relationship of Serum Uric Acid with Kidney Function Decline Mediated by Systemic Arterial Stiffness: A Retrospective Cohort Study in Japan |
| title_sort | relationship of serum uric acid with kidney function decline mediated by systemic arterial stiffness a retrospective cohort study in japan |
| topic | serum uric acid kidney function decline arterial stiffness cardio-ankle vascular index |
| url | https://www.mdpi.com/2075-4418/14/2/195 |
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