Uric Acid May Have a Role in CKD Development

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Higher serum uric acid (SUA) levels may independently contribute to the development of CKD, data suggest.

The finding is based on an analysis of data from the C8 Health Study, a population-based study of 49,295 Appalachian adults free from cardiovascular disease. The investigators, led by Anoop Shankar, MD, of the West Virginia University School of Medicine in Morgantown, observed a positive association between increasing quartiles of SUA and CKD, independent of age, gender, smoking status, alcohol intake, diabetes mellitus, hypertension, BMI, total cholesterol, and education. Compared with the patients in SUA quartile 1 (reference), those in quartiles 2, 3, and 4 had a 1.53, 2.16, and 4.67 times increased risk of CKD, the investigators reported in Nephrology Dialysis Transplantation (published online ahead of print).

Dr. Shankar and his colleagues noted that an association between SUA and kidney disease is biologically plausible. They cited a study showing that mild elevations of SUA in rats, even level within normal limits, can cause hypertension and renal microvascular disease.

“If supported by future prospective studies, uric acid-lowering medication may be an effective strategy to prevent and/or arrest CKD,” the authors concluded.

The researchers noted that their study's strengths included the large sample size and standardized methods of data collection. Major limitations included the study's cross-sectional design—which precluded drawing conclusions about the temporal association between SUA and CKD—and the predominately Caucasian makeup of the study population, which means that study findings may not be generalized to other populations.

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