DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20210444

Uric acid levels in chronic kidney disease- a hospital based cross-sectional study in RIMS, Ranchi, Jharkhand

Nivedita ., Abhishek Kumar, Abhishek Sinha, J. K. Mitra, Rashmi Sinha

Abstract


Background: Uric acid is the final end product of purine metabolism and is excreted mainly by proximal tubules of the kidney. Raised uric acid levels may lead to proximal tubular injury, endothelial dysfunction, oxidative stress and intra renal inflammation in patients with normal renal function. Uric acid has been deemed as an independent risk factor for progression of CKD. Aim was to study the uric acid levels in different stages of chronic kidney disease and its association with age, sex and other co-morbidities.

Methods: 140 patients of chronic kidney disease admitted in RIMS, Ranchi were included in this study and their serum uric acid level were analyzed. Uric acid level more than 7 mg/dl was considered as hyperuricemia. The study was approved by the Institutional Ethics Committee, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India. Informed consent was taken from every patient included in the study.

Results: Median age±SD was 55±13.47 years (IQR: 45,65; Range: 19-80). Mean±SD uric acid levels in stage 3 CKD was 4.4±1.9 mg/dl, stage 4 CKD was 6.5±4.1 mg/dl, stage 5 CKD was 8.8±3.1 mg/dl (p<0.05). Females were 31.4% and males were 69.6%. Male to female ratio was 2.2:1. The prevalence of hyperuricemia was 50% in females and 66.6% in males.

Conclusions: Hyperuricemia is common among CKD patients and more common among males. Uric acid levels increase with progressive decline in eGFR. Monitoring and follow-up of such patients by may lead to delay in onset and progression of complications of CKD.


Keywords


CKD, Nephropathy, Uric acid

Full Text:

PDF

References


Levin A, Rocco M. KDOQI clinical practice guidelines and clinical practice recommendations for anemia in chronic kidney disease. Am J Kidney Dis. 2006;47(5):S11-145.

Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2005;67(6):2089-100.

Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis. 2003;41(1):1-2.

Johnson RJ, Lanaspa MA, Gaucher EA. Uric acid: a danger signal from the RNA world that may have a role in the epidemic of obesity, metabolic syndrome, and cardiorenal disease: evolutionary considerations. Semin Nephrol. 2011;31(5):394-9.

Siu YP, Leung KT, Tong MKH, Kwan TH. Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis. 2006; 47(1):51-9.

Goicoechea M, Garcia de Vinuesa S, Verdalles U, Verde E, Macias N, Santos A, et al. Allopurinol and progression of CKD and cardiovascular events: long-term follow-up of a randomized clinical trial. Am J Kidney Dis. 2015;65(4):543-9.

Sircar D, Chatterjee S, Waikhom R, Golay V, Raychaudhury A, Chatterjee S, et al. Efficacy of febuxostat for slowing the GFR decline in patients with ckd and asymptomatic hyperuricemia: a 6-month, double-blind, randomized, placebo-controlled trial. Am J Kidney Dis. 2015;66(6):945-50.

Siu YP, Leung KT, Tong MK, Kwan TH. Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis. 2006;47(1):51-9.

Shi Y, Chen W, Jalal D, Li Z, Chen W, Mao H, et al. Clinical outcome of hyperuricemia in IgA nephropathy: a retrospective cohort study and randomized controlled trial. Kidney Blood Press Res. 2012;35(3):153-60.

Jha VK, Shashibhushan. Clinical profile of chronic kidney disease patients in a tertiary care hospital-an observational study. J Nephrol Kidney Dis. 2018;2(2):1016.

Nirav S, Swati A, Divyen K, Nency L, Atodadiya J, Arjun M. Evaluation of epidemiological and clinical profile of newly diagnosed cases of chronic kidney disease in a tertiary healthcare center: a prospective study. Int J Contemp Med Res. 2018;5(5).

Tsai CW, Lin SY, Kuo CC, Huang CC. Serum uric acid and progression of kidney disease: a longitudinal analysis and mini-review. PLoS One. 2017;12(1):e0170393.

Chini LSN, Assis LIS, Lugon JR. Relationship between uric acid levels and risk of chronic kidney disease in a retrospective cohort of Brazilian workers. Brazilian J Med Biol Res. 2017;50(9):e6048.

Chonchol M, Shlipak MG, Katz R, Sarnak MJ, Newman AB, Siscovick DS, et al. Relationship of uric acid with progression of kidney disease. Am J Kidney Dis. 2007;50(2):239-47.

Mok Y, Lee SJ, Kim MS, Cui W, Moon YM, Jee SH. Serum uric acid and chronic kidney disease: the Severance cohort study. Nephrol Dial Transpl. 2012;27(5):1831–5.

Wen CP, Cheng DTY, Chan HT, Tsai MK, Chung WS, Tsai SP, et al. Is high serum uric acid a risk marker or a target for treatment? Examination of its independent effect in a large cohort with low cardiovascular risk. Am J Kidney Dis. 2010;56(2):273-88.

Yamada T, Fukatsu M, Suzuki S, Wada T, Joh T. Elevated serum uric acid predicts chronic kidney disease. Am J Med Sci. 2011;342(6):461-6.

Altemtam N, Russell J, El Nahas M. A study of the natural history of diabetic kidney disease (DKD). Nephrol Dial Transpl. 2012;27(5):1847-54.