J Prev Med Public Health.  2018 Sep;51(5):248-256. 10.3961/jpmph.18.112.

Effect of Uric Acid on the Development of Chronic Kidney Disease: The Korean Multi-Rural Communities Cohort Study

Affiliations
  • 1Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, Korea. dhshin@kmu.ac.kr
  • 2Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea.
  • 3Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea.

Abstract


OBJECTIVES
Several studies have investigated the effects of serum uric acid (SUA) levels on chronic kidney disease (CKD), with discrepant results. The effect of SUA levels on CKD development was studied in the Korean rural population.
METHODS
A total of 9695 participants aged ≥40 years were recruited from 3 rural communities in Korea between 2005 and 2009. Of those participants, 5577 who participated in the follow-up and did not have cerebrovascular disease, myocardial infarction, cancer, or CKD at baseline were studied. The participants, of whom 2133 were men and 3444 were women, were grouped into 5 categories according to their quintile of SUA levels. An estimated glomerular filtration rate of < 60 mL/min/1.73 m2 at the time of follow-up was considered to indicate newly developed CKD. The effects of SUA levels on CKD development after adjusting for potential confounders were assessed using Cox proportional hazard models.
RESULTS
Among the 5577 participants, 9.4 and 11.0% of men and women developed CKD. The hazard ratio (HR) of CKD was higher in the highest quintile of SUA levels than in the third quintile in men (adjusted HR, 1.60; 95% confidence interval [CI], 1.02 to 2.51) and women (adjusted HR, 1.56; 95% CI, 1.14 to 2.15). Furthermore, CKD development was also more common in the lowest quintile of SUA levels than in the third quintile in men (adjusted HR, 1.83; 95% CI, 1.15 to 2.90). The effect of SUA was consistent in younger, obese, and hypertensive men.
CONCLUSIONS
Both high and low SUA levels were risk factors for CKD development in rural Korean men, while only high levels were a risk factor in their women counterparts.

Keyword

Cohort studies; Chronic kidney disease; Uric acid; Korea

MeSH Terms

Cerebrovascular Disorders
Cohort Studies*
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Korea
Male
Myocardial Infarction
Proportional Hazards Models
Renal Insufficiency, Chronic*
Risk Factors
Rural Population
Uric Acid*
Uric Acid
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