Association between asymptomatic hyperuricemia and new-onset chronic kidney disease in Japanese male workers: a long-term retrospective cohort study

BMC Nephrology

Yoshiharu Aizawa²  Hiroyuki Terawaki¹  Hiroshi Ohta²  Koji Wada²  Masatoshi Kawashima³ 

[1] Division of Kidney and Hypertension, The Jikei University School of Medicine Kashiwa Hospital, Kashiwa, Japan;Department of Preventive Medicine and Public Health, Kitasato University School of Medicine, Sagamihara, Japan;Department of Occupational Health, Graduate School of Medical Sciences, Kitasato University School of Medicine, Sagamihara, Japan

关键词: Japan;    cohort;    glomerular filtration rate;    hyperuricemia;    chronic kidney disease;   

Others  :  1083252
DOI  :  10.1186/1471-2369-12-31

 received in 2010-10-08, accepted in 2011-07-02,  发布年份 2011

【 摘 要 】

Background

Hyperuricemia is prevalent in patients with chronic kidney disease (CKD). We explored the hypothesis that asymptmatic hyperuricemia may be associated with new-onset CKD.

Methods

The participants were all male factory workers in Kanagawa, Japan (n = 1,285). All were over 40 years of age and had undergone annual health examinations from 1990 to 2007. Individuals with a history of gouty attacks were excluded from the study. A retrospective cohort study was conducted by following the estimated glomerular filtration rate (eGFR) for each participant over a maximum period of 18 years. The endpoint was new-onset CKD defined as eGFR < 60 mL/min/1.73 m². The associations between new-onset CKD and the presence of hyperuricemia, low serum high-density lipoprotein cholesterol, hypertension, diabetes, and obesity were analyzed.

Results

The mean (± standard deviation) follow-up period was 95.2 (± 66.7) months, and new-onset CKD was observed in 100 participants (7.8%) during this follow-up. Cox proportional hazards model revealed that the hazard ratio of new-onset CKD due to hyperuricemia, low serum high-density lipoprotein cholesterol, hypertension and obesity were 3.99 (95% confidence interval: 2.59-6.15), 1.69 (1.00-2.86), 2.00 (1.29-3.11) and 1.35 (0.87-2.10), respectively. Concerning hyperuricemia, low serum high-density lipoprotein cholesterol, hypertension and obesity, the log-rank tests showed P values of < 0.01, 0.01, < 0.01 and < 0.01, respectively.

Conclusion

The results of this study suggest that asymptomatic hyperuricemia is a predictive factor for new-onset CKD for Japanese male workers.

【 授权许可】

   
2011 Kawashima et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification Am J Kidney Dis 2002, 39(2 Suppl 1):S1-266.
• [2]Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, Van Lente F, Levey AS: Prevalence of chronic kidney disease in the United States. JAMA 2007, 298(17):2038-2047.
• [3]Imai E, Horio M, Watanabe T, Iseki K, Yamagata K, Hara S, Ura N, Kiyohara Y, Moriyama T, Ando Y, Fujimoto S, Konta T, Yokoyama H, Makino H, Hishida A, Matsuo S: Prevalence of chronic kidney disease in the Japanese general population. Clin Exp Nephrol 2009, 13(6):621-630.
• [4]Walker WG, Neaton JD, Cutler JA, Neuwirth R, Cohen JD: Renal function change in hypertensive members of the Multiple Risk Factor Intervention Trial. Racial and treatment effects. The MRFIT Research Group. JAMA 1992, 268(21):3085-3091.
• [5]Bakris GL, Williams M, Dworkin L, Elliott WJ, Epstein M, Toto R, Tuttle K, Douglas J, Hsueh W, Sowers J: Preserving renal function in adults with hypertension and diabetes: a consensus approach. National Kidney Foundation Hypertension and Diabetes Executive Committees Working Group. Am J Kidney Dis 2000, 36(3):646-661.
• [6]Yamagata K, Ishida K, Sairenchi T, Takahashi H, Ohba S, Shiigai T, Narita M, Koyama A: Risk factors for chronic kidney disease in a community-based population: a 10-year follow-up study. Kidney Int 2007, 71(2):159-166.
• [7]Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D: Predictors of new-onset kidney disease in a community-based population. JAMA 2004, 291(7):844-850.
• [8]Tozawa M, Iseki K, Iseki C, Kinjo K, Ikemiya Y, Takishita S: Blood pressure predicts risk of developing end-stage renal disease in men and women. Hypertension 2003, 41(6):1341-1345.
• [9]Vupputuri S, Batuman V, Muntner P, Bazzano LA, Lefante JJ, Whelton PK, He J: Effect of blood pressure on early decline in kidney function among hypertensive men. Hypertension 2003, 42(6):1144-1149.
• [10]Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR: Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int 2003, 63(1):225-232.
• [11]Araki S, Haneda M, Sugimoto T, Isono M, Isshiki K, Kashiwagi A, Koya D: Factors associated with frequent remission of microalbuminuria in patients with type 2 diabetes. Diabetes 2005, 54(10):2983-2987.
• [12]Ruggenenti P, Fassi A, Ilieva AP, Bruno S, Iliev IP, Brusegan V, Rubis N, Gherardi G, Arnoldi F, Ganeva M, Ene-Iordache B, Gaspari F, Perna A, Bossi A, Trevisan R, Dodesini AR, Remuzzi G: Preventing microalbuminuria in type 2 diabetes. N Engl J Med 2004, 351(19):1941-1951.
• [13]Andersen S, Brochner-Mortensen J, Parving HH: Kidney function during and after withdrawal of long-term irbesartan treatment in patients with type 2 diabetes and microalbuminuria. Diabetes Care 2003, 26(12):3296-3302.
• [14]Schaeffner ES, Kurth T, Curhan GC, Glynn RJ, Rexrode KM, Baigent C, Buring JE, Gaziano JM: Cholesterol and the risk of renal dysfunction in apparently healthy men. J Am Soc Nephrol 2003, 14(8):2084-2091.
• [15]Muntner P, Coresh J, Smith JC, Eckfeldt J, Klag MJ: Plasma lipids and risk of developing renal dysfunction: the atherosclerosis risk in communities study. Kidney Int 2000, 58(1):293-301.
• [16]Iseki K, Ikemiya Y, Kinjo K, Inoue T, Iseki C, Takishita S: Body mass index and the risk of development of end-stage renal disease in a screened cohort. Kidney Int 2004, 65(5):1870-1876.
• [17]Obermayr RP, Temml C, Gutjahr G, Knechtelsdorfer M, Oberbauer R, Klauser-Braun R: Elevated uric acid increases the risk for kidney disease. J Am Soc Nephrol 2008, 19(12):2407-2413.
• [18]Madero M, Sarnak MJ, Wang X, Greene T, Beck GJ, Kusek JW, Collins AJ, Levey AS, Menon V: Uric acid and long-term outcomes in CKD. Am J Kidney Dis 2009, 53(5):796-803.
• [19]Iseki K, Ikemiya Y, Inoue T, Iseki C, Kinjo K, Takishita S: Significance of hyperuricemia as a risk factor for developing ESRD in a screened cohort. Am J Kidney Dis 2004, 44(4):642-650.
• [20]Ohno I, Hosoya T, Gomi H, Ichida K, Okabe H, Hikita M: Serum uric acid and renal prognosis in patients with IgA nephropathy. Nephron 2001, 87(4):333-339.
• [21]Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, Yamagata K, Tomino Y, Yokoyama H, Hishida A: Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 2009, 53(6):982-992.
• [22]Hallan S, Asberg A, Lindberg M, Johnsen H: Validation of the Modification of Diet in Renal Disease formula for estimating GFR with special emphasis on calibration of the serum creatinine assay. Am J Kidney Dis 2004, 44(1):84-93.
• [23]Cox D: Regression Models and Life-Tables. J R Stat Soc Ser B 1972, 34(2):187-220.
• [24]Kaplan EL, Meier P: Nonparametric Estimation from Incomplete Observations. J Am Stat Assoc 1958, 53(282):457-481.
• [25]SPSS. SPSS for Windows VJ: Chicago: SPSS Inc. 2008.
• [26]Siu YP, Leung KT, Tong MK, Kwan TH: Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis 2006, 47(1):51-59.
• [27]Perez-Ruiz F, Calabozo M, Herrero-Beites AM, Garcia-Erauskin G, Pijoan JI: Improvement of renal function in patients with chronic gout after proper control of hyperuricemia and gouty bouts. Nephron 2000, 86(3):287-291.
• [28]Guideline for the management of hyperuricemia and gout (in Japanese) Japanese Society of Gout and Nucleic Acid Metabolosm 2002.
• [29]Ravid M, Brosh D, Ravid-Safran D, Levy Z, Rachmani R: Main risk factors for nephropathy in type 2 diabetes mellitus are plasma cholesterol levels, mean blood pressure, and hyperglycemia. Arch Intern Med 1998, 158(9):998-1004.
• [30]Appel GB, Radhakrishnan J, Avram MM, DeFronzo RA, Escobar-Jimenez F, Campos MM, Burgess E, Hille DA, Dickson TZ, Shahinfar S, Brenner BM: Analysis of metabolic parameters as predictors of risk in the RENAAL study. Diabetes Care 2003, 26(5):1402-1407.
• [31]Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report Circulation 2002, 106(25):3143-3421.
• [32]Teramoto T, Sasaki J, Ueshima H, Egusa G, Kinoshita M, Shimamoto K, Daida H, Biro S, Hirobe K, Funahashi T, Yokote K, Yokode M: Diagnostic criteria for dyslipidemia. Executive summary of Japan Atherosclerosis Society (JAS) guideline for diagnosis and prevention of atherosclerotic cardiovascular diseases for Japanese. J Atheroscler Thromb 2007, 14(4):155-158.
• [33]Reynolds K, Gu D, Muntner P, Kusek JW, Chen J, Wu X, Duan X, Chen CS, Klag MJ, Whelton PK, He J: A population-based, prospective study of blood pressure and risk for end-stage renal disease in China. J Am Soc Nephrol 2007, 18(6):1928-1935.
• [34]Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Ford CE, Shulman NB, Stamler J: Blood pressure and end-stage renal disease in men. N Engl J Med 1996, 334(1):13-18.
• [35]Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ Jr: Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003, 42(6):1206-1252.
• [36]Ogihara T, Kikuchi K, Matsuoka H, Fujita T, Higaki J, Horiuchi M, Imai Y, Imaizumi T, Ito S, Iwao H, Kario K, Kawano Y, Kim-Mitsuyama S, Kimura G, Matsubara H, Matsuura H, Naruse M, Saito I, Shimada K, Shimamoto K, Suzuki H, Takishita S, Tanahashi N, Tsuchihashi T, Uchiyama M, Ueda S, Ueshima H, Umemura S, Ishimitsu T, Rakugi H: The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009). Hypertens Res 2009, 32(1):3-107.
• [37]Remuzzi G, Benigni A, Remuzzi A: Mechanisms of progression and regression of renal lesions of chronic nephropathies and diabetes. J Clin Invest 2006, 116(2):288-296.
• [38]Kramer H, Luke A, Bidani A, Cao G, Cooper R, McGee D: Obesity and prevalent and incident CKD: the Hypertension Detection and Follow-Up Program. Am J Kidney Dis 2005, 46(4):587-594.
• [39]Guideline for the Treatment of Obesity (in Japanese) Japan Society for the Study of Obesity 2006.
• [40]Imai E, Horio M, Nitta K, Yamagata K, Iseki K, Tsukamoto Y, Ito S, Makino H, Hishida A, Matsuo S: Modification of the Modification of Diet in Renal Disease (MDRD) Study equation for Japan. Am J Kidney Dis 2007, 50(6):927-937.