Hyperuricemia increases the risk for end-stage kidney disease (ESKD) among adults with minimal change disease (MCD), a new Korean study finds.

Of 800 patients diagnosed with MCD by kidney biopsy, 42 patients (5.3%) initiated dialysis or received kidney transplantation, Eun Hui Bae, MD, of Chonnam National University Medical School in Korea and colleagues reported in Kidney Research and Clinical Practice.

In a restricted cubic spline curve, serum uric acid levels correlated with ESKD. In a fully adjusted model, the risk for MCD progression increased significantly by 29% for every 1 mg/dL increment in baseline serum uric acid level. High serum uric acid levels, defined as more than 7 mg/dL in men and 6 mg/dL in women, also significantly increased the risk for MCD progression by 3.4-fold. Results held in a sensitivity analysis excluding renal events in the first year.

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MCD does not typically lead to ESKD in adults, Dr Bae’s team noted. Hyperuricemia may lead to MCD progression by several different biologic mechanisms, they suggested, such as podcyte loss, hypertension, arteriosclerosis, and immune-related injury.

“We suggest that screening for hyperuricemia in MCD patients would help identify high-risk groups for disease progression. It could help to manage the MCD patients in a timely manner.”


Song SH, Oh TR, Choi HS, et al. Hyperuricemia is a risk factor for the progression to end-stage renal disease in minimal change disease. Kidney Res Clin Pract 2021;40(3):411-418. doi:10.23876/j.krcp.20.220