Effect of uric acid on the development of chronic kidney disease: The Korean multi-rural communities cohort study

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. Ofthose participants, 5577 who participated in the follow-up and did not have cerebrovascular disease, myocardial infarction, cancer, orCKD 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 wasconsidered to indicate newly developed CKD. The effects of SUA levels on CKD development after adjusting for potential confounderswere 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 inthe 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) andwomen (adjusted HR, 1.56; 95% CI, 1.14 to 2.15). Furthermore, CKD development was also more common in the lowest quintile of SUAlevels 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 arisk factor in their women counterparts.