Miyeun Han 1 , Hayne Cho Park 1 , 2 , Hyunsuk Kim 1 , Hyung Ah Jo 1 , Hyuk Huh 1 , Joon Young Jang 3 , Ah-Young Kang 3 , 4 , Seung Hyup Kim 5 , 6 , Hae Il Cheong 2 , 6 , 7 , Duk-Hee Kang 8 , Jaeseok Yang 3 , 9 , Kook-Hwan Oh 1 , Young-Hwan Hwang , 2 , 10 , Curie Ahn , 1 , 3 , 6 , 9 , 11
16 April 2014
The role of hyperuricemia in disease progression of autosomal dominant polycystic kidney disease (ADPKD) has not been defined well. We investigated the association of serum uric acid (sUA) with renal function and the effect of hypouricemic treatment on the rate of renal function decline.
This is a single-center, retrospective, observational cohort study. A total of 365 patients with ADPKD who had estimated glomerular filtration rate (eGFR) ≥ 15 mL/min/1.73 m 2 and who were followed up for > 1 year were included in our analysis. Hyperuricemia was defined by a sUA level of ≥ 7.0 mg/dL in male and ≥ 6.0 mg/dL in female or when hypouricemic medications were prescribed.
Hyperuricemia was associated with reduced initial eGFR, independent of age, sex, hypertension, albuminuria, and total kidney volume. During a median follow-up period of over 6 years, patients with hyperuricemia showed a faster annual decline in eGFR (−6.3% per year vs. −0.9% per year, p = 0.008). However, after adjusting for age, sex, hypertension and initial eGFR, sUA was no longer associated with either annual eGFR decline or the development of ESRD. Among 53 patients who received hypouricemic treatment, the annual eGFR decline appeared to be attenuated after hypouricemic treatment (pretreatment vs. posttreatment: −5.3 ± 8. 2 vs. 0.2 ± 6.2 mL/min/1.73 m 2 per year, p = 0.001 by Wilcoxon signed-rank test).