Efficacy of different urinary uric acid indicators in patients with chronic kidney disease
Abstract Background Mounting studies have shown that hyperuricemia is related to kidney diseases through multiple ways. However, the application of urinary uric acid indicators in patients with reduced renal function is not clear. In this study, we aim to determine the effects of renal function on v...
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | BMC Nephrology |
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| Online Access: | http://link.springer.com/article/10.1186/s12882-020-01953-z |
| _version_ | 1818515429650333696 |
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| author | Haochen Guan Yuqi Zheng Xun Zhou Ying Xu Chensheng Fu Jing Xiao Zhibin Ye |
| author_facet | Haochen Guan Yuqi Zheng Xun Zhou Ying Xu Chensheng Fu Jing Xiao Zhibin Ye |
| author_sort | Haochen Guan |
| collection | DOAJ |
| description | Abstract Background Mounting studies have shown that hyperuricemia is related to kidney diseases through multiple ways. However, the application of urinary uric acid indicators in patients with reduced renal function is not clear. In this study, we aim to determine the effects of renal function on various indicators reflecting uric acid levels in patients with chronic kidney disease (CKD). Methods Anthropometric and biochemical examinations were performed in 625 patients with CKD recruited from Dept of Nephrology of Huadong hospital affiliated to Fudan University. Multiple regression analyses were used to study correlations of the estimated glomerular filtration rate (eGFR) with serum uric acid (SUA) and renal handling of uric acid. For further study, smooth curve plots and threshold effect analyses were applied to clarify associations between renal function and uric acid levels. Results The nonlinear relationships were observed between eGFR and urinary uric acid indicators. The obvious inflection points were observed in smooth curve fitting of eGFR and fractional excretion of uric acid (FEur), excretion of uric acid per volume of glomerular filtration (EurGF). In subsequent analyses where levels of eGFR< 15 mL/min/1.73m2 were dichotomized (CKD5a/CKD5b), patients in the CKD5a showed higher levels of FEur and EurGF while lower levels of urinary uric acid excretion (UUA), clearance of uric acid (Cur) and glomerular filtration load of uric acid (FLur) compared with CKD5b group (all P < 0.05). And there was no significant difference of SUA levels between two groups. On the other hand, when eGFR< 109.9 ml/min/1.73 m2 and 89.1 ml/min/1.73 m2, the resultant curves exhibited approximately linear associations of eGFR with Cur and FLur respectively. Conclusion FEur and EurGF showed significantly compensatory increases with decreased renal function. And extra-renal uric acid excretion may play a compensatory role in patients with severe renal impairment to maintain SUA levels. Moreover, Cur and FLur may be more reliable indicators of classification for hyperuricemia in CKD patients. |
| first_indexed | 2024-12-11T00:28:46Z |
| format | Article |
| id | doaj.art-73f6d70d531f483db00f9eb0a46b7fe6 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-11T00:28:46Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-73f6d70d531f483db00f9eb0a46b7fe62022-12-22T01:27:26ZengBMCBMC Nephrology1471-23692020-07-012111910.1186/s12882-020-01953-zEfficacy of different urinary uric acid indicators in patients with chronic kidney diseaseHaochen Guan0Yuqi Zheng1Xun Zhou2Ying Xu3Chensheng Fu4Jing Xiao5Zhibin Ye6Department of Nephrology, Huadong Hospital affiliated to Fudan UniversityDepartment of Nephrology, Huadong Hospital affiliated to Fudan UniversityDepartment of Nephrology, Huadong Hospital affiliated to Fudan UniversityDepartment of Nephrology, Huadong Hospital affiliated to Fudan UniversityDepartment of Nephrology, Huadong Hospital affiliated to Fudan UniversityDepartment of Nephrology, Huadong Hospital affiliated to Fudan UniversityDepartment of Nephrology, Huadong Hospital affiliated to Fudan UniversityAbstract Background Mounting studies have shown that hyperuricemia is related to kidney diseases through multiple ways. However, the application of urinary uric acid indicators in patients with reduced renal function is not clear. In this study, we aim to determine the effects of renal function on various indicators reflecting uric acid levels in patients with chronic kidney disease (CKD). Methods Anthropometric and biochemical examinations were performed in 625 patients with CKD recruited from Dept of Nephrology of Huadong hospital affiliated to Fudan University. Multiple regression analyses were used to study correlations of the estimated glomerular filtration rate (eGFR) with serum uric acid (SUA) and renal handling of uric acid. For further study, smooth curve plots and threshold effect analyses were applied to clarify associations between renal function and uric acid levels. Results The nonlinear relationships were observed between eGFR and urinary uric acid indicators. The obvious inflection points were observed in smooth curve fitting of eGFR and fractional excretion of uric acid (FEur), excretion of uric acid per volume of glomerular filtration (EurGF). In subsequent analyses where levels of eGFR< 15 mL/min/1.73m2 were dichotomized (CKD5a/CKD5b), patients in the CKD5a showed higher levels of FEur and EurGF while lower levels of urinary uric acid excretion (UUA), clearance of uric acid (Cur) and glomerular filtration load of uric acid (FLur) compared with CKD5b group (all P < 0.05). And there was no significant difference of SUA levels between two groups. On the other hand, when eGFR< 109.9 ml/min/1.73 m2 and 89.1 ml/min/1.73 m2, the resultant curves exhibited approximately linear associations of eGFR with Cur and FLur respectively. Conclusion FEur and EurGF showed significantly compensatory increases with decreased renal function. And extra-renal uric acid excretion may play a compensatory role in patients with severe renal impairment to maintain SUA levels. Moreover, Cur and FLur may be more reliable indicators of classification for hyperuricemia in CKD patients.http://link.springer.com/article/10.1186/s12882-020-01953-zChronic kidney diseaseSerum uric acidUrinary uric acid indicatorsRenal function |
| spellingShingle | Haochen Guan Yuqi Zheng Xun Zhou Ying Xu Chensheng Fu Jing Xiao Zhibin Ye Efficacy of different urinary uric acid indicators in patients with chronic kidney disease BMC Nephrology Chronic kidney disease Serum uric acid Urinary uric acid indicators Renal function |
| title | Efficacy of different urinary uric acid indicators in patients with chronic kidney disease |
| title_full | Efficacy of different urinary uric acid indicators in patients with chronic kidney disease |
| title_fullStr | Efficacy of different urinary uric acid indicators in patients with chronic kidney disease |
| title_full_unstemmed | Efficacy of different urinary uric acid indicators in patients with chronic kidney disease |
| title_short | Efficacy of different urinary uric acid indicators in patients with chronic kidney disease |
| title_sort | efficacy of different urinary uric acid indicators in patients with chronic kidney disease |
| topic | Chronic kidney disease Serum uric acid Urinary uric acid indicators Renal function |
| url | http://link.springer.com/article/10.1186/s12882-020-01953-z |
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