Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study.

<h4>Background</h4>Hyperuricemia is highly prevalent in chronic kidney disease (CKD) patients, but the evidence for a relationship between uric acid (UA) and clinical outcomes in CKD patients is limited and inconsistent. We hypothesized that UA has a different impact on clinical outcomes...

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Autores principales:	Kimio Watanabe, Masaaki Nakayama, Tae Yamamoto, Gen Yamada, Hiroshi Sato, Mariko Miyazaki, Sadayoshi Ito
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2633d03062a348a58fc9c181bdb4aac2
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spelling	oai:doaj.org-article:2633d03062a348a58fc9c181bdb4aac22021-11-25T06:19:23ZDifferent clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study.1932-620310.1371/journal.pone.0249240https://doaj.org/article/2633d03062a348a58fc9c181bdb4aac22021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0249240https://doaj.org/toc/1932-6203<h4>Background</h4>Hyperuricemia is highly prevalent in chronic kidney disease (CKD) patients, but the evidence for a relationship between uric acid (UA) and clinical outcomes in CKD patients is limited and inconsistent. We hypothesized that UA has a different impact on clinical outcomes according to the underlying disease causing CKD.<h4>Methods</h4>This study prospectively investigated the associations between UA and renal and non-renal outcomes according to the underlying disease causing CKD in 2,797 Japanese patients under the care of nephrologists. The patients were categorized into four groups: primary renal disease (n = 1306), hypertensive nephropathy (n = 467), diabetic nephropathy (n = 275), and other nephropathy (n = 749). The renal outcome was defined as end-stage renal disease (ESRD), and the non-renal outcome was defined as a composite endpoint of cardiovascular events (CVEs) and all-cause mortality.<h4>Results</h4>During a median 4.8-year follow-up, 359 (12.8%) patients reached the renal outcome, and 260 (9.3%) reached the non-renal outcome. In the all-patient analysis, hyperuricemia was not associated with the risks for renal and non-renal outcomes, but in primary renal disease (PRD) and hypertensive renal disease (HTN) patients, hyperuricemia was significantly associated with non-renal outcomes. Per 1 mg/dl higher UA level, multivariable adjusted hazard ratio was 1.248 (95% CI: 1.003 to 1.553) for PRD, and 1.250 (1.035 to 1.510) for HTN. Allopurinol did not reduce the risks for renal and non-renal outcomes, both in all patients and in the subgroup analysis.<h4>Conclusions</h4>The effect of hyperuricemia on clinical outcomes in CKD patients varies according to the underlying disease causing CKD. Hyperuricemia is an independent risk factor for non-renal outcomes in primary renal disease and hypertensive renal disease patients. Allopurinol did not decrease the risks for renal and non-renal outcomes.Kimio WatanabeMasaaki NakayamaTae YamamotoGen YamadaHiroshi SatoMariko MiyazakiSadayoshi ItoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 3, p e0249240 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kimio Watanabe Masaaki Nakayama Tae Yamamoto Gen Yamada Hiroshi Sato Mariko Miyazaki Sadayoshi Ito Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study.
description	<h4>Background</h4>Hyperuricemia is highly prevalent in chronic kidney disease (CKD) patients, but the evidence for a relationship between uric acid (UA) and clinical outcomes in CKD patients is limited and inconsistent. We hypothesized that UA has a different impact on clinical outcomes according to the underlying disease causing CKD.<h4>Methods</h4>This study prospectively investigated the associations between UA and renal and non-renal outcomes according to the underlying disease causing CKD in 2,797 Japanese patients under the care of nephrologists. The patients were categorized into four groups: primary renal disease (n = 1306), hypertensive nephropathy (n = 467), diabetic nephropathy (n = 275), and other nephropathy (n = 749). The renal outcome was defined as end-stage renal disease (ESRD), and the non-renal outcome was defined as a composite endpoint of cardiovascular events (CVEs) and all-cause mortality.<h4>Results</h4>During a median 4.8-year follow-up, 359 (12.8%) patients reached the renal outcome, and 260 (9.3%) reached the non-renal outcome. In the all-patient analysis, hyperuricemia was not associated with the risks for renal and non-renal outcomes, but in primary renal disease (PRD) and hypertensive renal disease (HTN) patients, hyperuricemia was significantly associated with non-renal outcomes. Per 1 mg/dl higher UA level, multivariable adjusted hazard ratio was 1.248 (95% CI: 1.003 to 1.553) for PRD, and 1.250 (1.035 to 1.510) for HTN. Allopurinol did not reduce the risks for renal and non-renal outcomes, both in all patients and in the subgroup analysis.<h4>Conclusions</h4>The effect of hyperuricemia on clinical outcomes in CKD patients varies according to the underlying disease causing CKD. Hyperuricemia is an independent risk factor for non-renal outcomes in primary renal disease and hypertensive renal disease patients. Allopurinol did not decrease the risks for renal and non-renal outcomes.
format	article
author	Kimio Watanabe Masaaki Nakayama Tae Yamamoto Gen Yamada Hiroshi Sato Mariko Miyazaki Sadayoshi Ito
author_facet	Kimio Watanabe Masaaki Nakayama Tae Yamamoto Gen Yamada Hiroshi Sato Mariko Miyazaki Sadayoshi Ito
author_sort	Kimio Watanabe
title	Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study.
title_short	Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study.
title_full	Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study.
title_fullStr	Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study.
title_full_unstemmed	Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study.
title_sort	different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: gonryo study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/2633d03062a348a58fc9c181bdb4aac2
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_version_	1718413852537782272

Different clinical impact of hyperuricemia according to etiologies of chronic kidney disease: Gonryo Study.

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