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Development of Nephrolithiasis in Asymptomatic Hyperuricemia: A Cohort Study

Title
Development of Nephrolithiasis in Asymptomatic Hyperuricemia: A Cohort Study
Author
이수진
Keywords
Nephrolithiasis; uric acid; hyperuricemia; cohort study; risk factor; urinary stones; kidney stone; abdominal ultrasound; sex differences; Korea
Issue Date
2017-10
Publisher
W B SAUNDERS CO-ELSEVIER INC
Citation
AMERICAN JOURNAL OF KIDNEY DISEASES, v. 70, no. 2, page. 173-181
Abstract
Background: Although the association between gout and nephrolithiasis is well known, the relationship between asymptomatic hyperuricemia and the development of nephrolithiasis is largely unknown.Study Design: Cohort study.Setting & Participants: 239,331 Korean adults who underwent a health checkup examination during January 2002 to December 2014 and were followed up annually or biennially through December 2014.Predictor: Baseline serum uric acid levels of participants.Outcome: The development of nephrolithiasis during follow-up.Measurements: Nephrolithiasis is determined based on ultrasonographic findings. A parametric Cox model was used to estimate the adjusted HRs of nephrolithiasis according to serum uric acid level.Results: During 1,184,653.8 person-years of follow-up, 18,777 participants developed nephrolithiasis (incidence rate, 1.6/100 person-years). Elevated uric acid level was significantly associated with increased risk for nephrolithiasis in a dose-response manner (P for trend, 0.001) in men. This dose-response association was not observed in women. In male participants, multivariable-adjusted HRs for incident nephrolithiasis comparing uric acid levels of 6.0 to 6.9, 7.0 to 7.9, 8.0 to 8.9, 9.0 to 9.9, and $10.0 mg/dL with uric acid levels, 6.0 mg/dL were 1.06 (95% CI, 1.02-1.11), 1.11 (95% CI, 1.05-1.16), 1.21 (95% CI, 1.13-1.29), 1.31 (95% CI, 1.17-1.46), and 1.72 (95% CI, 1.44-2.06), respectively. This association was observed in all clinically relevant subgroups and persisted even after adjustment for homeostasis model assessment of insulin resistance and high-sensitivity C-reactive protein level.Limitations: Dietary information and computed tomographic diagnosis of nephrolithiasis were unavailable.Conclusions: In this large cohort study, increased serum uric acid level was modestly and independently associated with increased risk for the development of nephrolithiasis in a dose-response manner in apparently healthy men. (C) 2017 by the National Kidney Foundation, Inc.
URI
https://www.ajkd.org/article/S0272-6386(17)30548-6/fulltexthttp://repository.hanyang.ac.kr/handle/20.500.11754/115789
ISSN
0272-6386; 1523-6838
DOI
10.1053/j.ajkd.2017.01.053
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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