Evaluation of Serum Uric Acid and its Correlation with Decline in Estimated Glomerular Filtration Rate among the Chronic Kidney Disease Patients

Authors

DOI:

https://doi.org/10.25159/2520-5293/12817

Keywords:

serum uric acid, chronic kidney disease, body mass index (BMI), estimated glomerular filtration rate

Abstract

Background: Chronic kidney disease is one of the most serious public health burdens globally, with significant morbidity, mortality, and reduced patient life expectancy. Many sub-Saharan African countries face double-burden challenges in the treatment of chronic kidney disease and its complications. This study aims to evaluate serum uric acid and its correlation with estimated glomerular filtration rate, as well as other risk factors among chronic kidney disease patients on follow-up at Jimma University specialised referral hospital.

Method: A hospital-based cross-sectional study was conducted at Jimma University Medical Centre from August 6, 2022, to November 13, 2022. Using a consecutive sampling technique, a total of 140 CKD follow-up patients were recruited into the current study. Data were collected using interviewer-based structured questionnaires, record reviews, and physical examinations. The collected data were analysed by SPSS version 25.0. The correlation between eGFR and uric acid concentrations was examined by Pearson’s correlation analyses. Univariate and multivariate linear regression were used to test predictors of serum uric acid in the study participants.

Result: A total of 140 study participants were recruited for this study. Subjects included (54.3% [n=76]) men and (45.7% [n=64]) women, respectively. The mean (SD) age of the study subjects was 51.04±9.02 years. The mean value of serum uric acid was 7.2±2.1mg/dl, whereas the mean of estimated glomerular filtration rate (eGFR) was 54.2±31 mL/min/1.73m2. Furthermore, the mean values of serum creatinine and blood urea nitrogen among participants in this study were 3.2±1.4 and 67.8±35.8 mg/dL. In the current study, estimated glomerular filtration rate (eGFR) value was negatively correlated (r=-0.912, P<0.001) with uric acid. However, systolic blood pressure was positively correlated (r=0.584, P<0.001) with uric acid. Moreover, the eGFR value was negatively associated (β=-0.060, P=<0.001) with uric acid among study participants.

Conclusion: Based on the current study findings, an increase in serum uric acid was associated with a decrease in eGFR value. Increased serum uric acid, increased body mass index (BMI) and high blood pressure are independent risk factors for disease progression in patients with CKD.

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References

Aiumtrakul, N., P. Wiputhanuphongs, and O. Supasyndh. 2021. “Hyperuricemia and Impaired Renal Function: A Prospective Cohort Study,” 210–218. https://doi.org/10.1159/000511196.

Akasaka, H., H. Yoshida, H. Takizawa, N. Hanawa, T. Tobisawa, M. Tanaka, N. Moniwa, N. Togashi, T. Yamashita, S. Kuroda, N. Ura, and T. M. B. Investigators. 2014. “The Impact of Elevation of Serum Uric Acid Level on the Natural History of Glomerular Filtration Rate (GFR) and its Sex Difference,” 1–8. https://doi.org/10.1093/ndt/gfu197.

Ali, N., S. Mahmood, F. Islam, S. Rahman, and T. Haque. 2019. “Relationship between Serum Uric Acid and Hypertension: A Cross-sectional Study in Bangladeshi Adults,” June, 1–7. https://doi.org/10.1038/s41598-019-45680-4.

Ammirati, A. L. 2020. “Chronic Kidney Disease.” Journal of Internal Medicine and Nephrology 6. https://doi.org/10.1590/1806-9282.66.s1.3.

Barata, R., F. Cardoso, and T. A. Pereira. 2020. “Hyperuricemia in Chronic Kidney Disease: A Role yet to be Explained.” 34 (6) (March): 30–35. https://doi.org/10.32932/pjnh.2020.04.060.

Boon, A., A. C. Bulmer, J. S. Coombes, and R. G. Fassett. 2014. “Novel Therapeutics in Renal Diseases Circulating Bilirubin and Defense against Kidney Disease and Cardiovascular Mortality: Mechanisms Contributing to Protection in Clinical Investigations,” 2. https://doi.org/10.1152/ajprenal.00039.2014.

Badve, Sunil V., Elaine M. Pascoe, Anushree Tiku, Neil Boudville, Fiona G. Brown, Alan Cass, Philip Clarke, Nicola Dalbeth, Richard O. Day, Janak R. de Zoysa, Bettina Douglas, Randall Faull, et al. 2020. “Effects of Allopurinol on the Progression of Chronic Kidney Disease,” 2504–2513. https://doi.org/10.1056/NEJMoa1915833.

Caleb, P., J. Lima, J. E. Krieger, and A. C. Pereira. 2012. “Renin Angiotensin System, Hypertension, and Chronic Kidney Disease: Pharmacogenetic Implications Angiotensin II Receptors Bradykinin Receptors Kininogen,” 88, 77–88. https://doi.org/10.1254/jphs.12R03CR.

Chang, W. X., N. Xu, T. Kumagai, R. Iijima, M. Yamanaka, M. Nagura, S. Arai, Y. Tamura, S. Shibata, Y. Fujigaki, and S. Uchida. 2017. “Uric Acid in the Follow-up Determines 30% Decline in Estimated GFR Over 2 Years: A Propensity Score Analysis,” 8605, 1053–1067. https://doi.org/10.1159/000485593.

Choi, Hyon K., David B. Mount, and Anthony M. Reginato. 2005. “Physiology in Medicine: A Series of Articles Linking Medicine with Science Review Pathogenesis of Gout.” Annals of Internal Medicine 143 (7): 499–516. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3117776&tool=pmcentrez&rendertype=abstract. https://doi.org/10.7326/0003-4819-143-7-200510040-00009.

Delanaye, P., E. Cavalier, and H. Pottel. 2017. “Serum Creatinine: Not so Simple!” Nephron 136 (4): 302–308. https://doi.org/10.1159/000469669.

Drummond, C. A., P. S. Brewster, W. He, K. Ren, Y. Xie, K. R. Tuttle, S. T. Haller, K. Jamerson, L. D. Dworkin, E. Cutlip, T. P. Murphy, R. B. D. Agostino, W. L. Henrich, J. Tian, J. I. Shapiro, and C. J. Cooper. 2017. “Cigarette Smoking and Cardio-renal Events in Patients with Atherosclerotic Renal Artery Stenosis,” 1–15. https://doi.org/10.1371/journal.pone.0173562.

Fiseha, T., M. K. Ahmed, and T. Yemane. 2014. “Chronic Kidney Disease and Underdiagnosis of Renal Insufficiency among Diabetic Patients Attending a Hospital in Southern Ethiopia. December.” https://doi.org/10.1186/1471-2369-15-198.

Funakoshi, Y., and H. Omori. 2012. “Association between Frequency of Drinking Alcohol and Chronic Kidney Disease in Men,” 199–204. https://doi.org/10.1007/s12199-011-0238-6.

Galán, I., M. Goicoechea, B. Quiroga, N. Macías, A. Santos, E. Verde, M. Soledad, G. Vinuesa, Ú de Verdalles, S. Cede, A. P. José, A. de García, and J. Lu. 2017. “Hyperuricemia is Associated with Progression of Chronic Kidney Disease in Patients with Reduced Functioning Kidney Mass.” 8: 73–78. https://doi.org/10.1016/j.nefro.2017.04.006.

Giordano, C., O. Karasik, K. King-Morris, and A. Asmar. 2015. “Uric Acid as a Marker of Kidney Disease: Review of the Current Literature. https://doi.org/10.1155/2015/382918.

Gu, L., L. Huang, H. Wu, Q. Lou, and R. Bian. 2017b. “Serum Uric Acid to Creatinine Ratio: A Predictor of Incident Chronic Kidney Disease in Type 2 Diabetes Mellitus Patients with Preserved Kidney Function.” Diabetes and Vascular Disease Research 14 (3): 221–225. https://doi.org/10.1177/1479164116680318.

Guan, H., Y. Zheng, X. Zhou, Y. Xu, C. Fu, J. Xiao, and Z. Ye. 2020. “Efficacy of Different Urinary Uric Acid Indicators in Patients with Chronic Kidney Disease,” 1–9. https://doi.org/10.1186/s12882-020-01953-z.

Hall, V., R. W. Thomsen, O. Henriksen, and N. Lohse. 2011. “Diabetes in Sub Saharan Africa 1999–2011: Epidemiology and Public Health Implications. A Systematic Review.” Vol. 5: 71–75. https://doi.org/10.1186/1471-2458-11-564.

Han, S. S., K. Y. Na, D. Chae, Y. S. Kim, S. Kim, and H. J. Chin. 2010. “High Serum Bilirubin Is Associated with the Reduced Risk of Diabetes Mellitus and Diabetic Nephropathy,” 133–140. https://doi.org/10.1620/tjem.221.133.

Jha, J. C., F. Ho, C. Dan, and K. Jandeleit-Dahm. 2018. “A Causal Link between Oxidative Stress and Inflammation in Cardiovascular and Renal Complications of Diabetes,” April, 1811–1836. https://doi.org/10.1042/CS20171459.

Kritmetapak, K., S. Charoensri, R. Thaopanya, and C. Pongchaiyakul. 2020. Elevated Serum Uric Acid is Associated with Rapid Decline in Kidney Function: A 10-year Follow-up Study. https://doi.org/10.2147/IJGM.S277957.

Kubo, S., Y. Nishida, Y. Kubota, A. Higashiyama, D. Sugiyama, T. Hirata, N. Miyamatsu, A. Tanabe, A. Hirata, Y. Tatsumi, A. Kadota, K. Kuwabara, T. Nishikawa, Y. Miyamoto, and T. Okamura. 2019. Higher Serum Uric Acid Level Is Inversely Associated with Renal Function Assessed by Cystatin C in a Japanese General Population without Chronic Kidney Disease: The KOBE Study, 1–8. https://doi.org/10.1186/s12882-019-1291-4.

Lee, J. J., J. Ahn, J. Hwang, S. W. Han, K. N. Lee, J. B. Kim, S. Lee, J. O. Na, H. E. Lim, J. W. Kim, S. Rha, C. G. Park, and H. S. Seo. 2015. “Relationship between Uric Acid and Blood Pressure in Different Age Groups.” Clinical Hypertension, 1–7. https://doi.org/10.1186/s40885-015-0022-9.

Levey, A. S., R. Atkins, J. Coresh, E. P. Cohen, A. J. Collins, K. U. Eckardt, M. E. Nahas, B. L. Jaber, M. Jadoul, A. Levin, N. R. Powe, J. Rossert, D. C. Wheeler, N. Lameire, and G. Eknoyan. 2007. “Chronic Kidney Disease as a Global Public Health Problem: Approaches and Initiatives. A Position Statement from Kidney Disease Improving Global Outcomes.” Kidney International 72 (3): 247–259. https://doi.org/10.1038/sj.ki.5002343.

Milik, A., and E. Hrynkiewicz. 2014. On Translation of LD, IL and SFC Given According to IEC-61131 for Hardware Synthesis of Reconfigurable Logic Controller. Ld, 4477–4483. https://doi.org/10.3182/20140824-6-ZA-1003.01333.

Miyatake, N., K. Shikata, H. Makino, and T. Numata. 2013. “Decreasing Serum Uric Acid Levels Are Associated with Improving Estimated Glomerular Filtration Rate ( eGFR ) in Japanese Women.” 2013 (May): 40–43. https://doi.org/10.4236/ojepi.2013.32007.

Nagasawa, Y., R. Yamamoto, H. Rakugi, and Y. Isaka. 2012. “Cigarette Smoking and Chronic Kidney Diseases.” 2011 (December): 261–265. https://doi.org/10.1038/hr.2011.205.

Niang, A., and A.T. Lemrabott. 2020. “Global Dialysis Perspective: Senegal.” Kidney360 1 (6): 538–540. https://doi.org/10.34067/kid.0000882020.

Ohta, Y., T. Tsuchihashi, K. Kiyohara, and H. Onik. 2013. “Increased Uric Acid Promotes Decline of the Renal Function in Hypertensive Patients: A 10-year Observational Study.” Internal Medicine 52 (13): 1467–1472. https://doi.org/10.2169/internalmedicine.52.0141.

Sedaghat, S., E. J. Hoorn, F. J. A. Rooij, A. van, Hofman, O. H. Franco, J. C. M Witteman, and A. Dehghan. 2013. “Serum Uric Acid and Chronic Kidney Disease: The Role of Hypertension.” 8 (11): 1–8. https://doi.org/10.1371/journal.pone.0076827.

Stec, D. E., P. A. Hosick, and P. Joey. 2012. “Bilirubin, Renal Hemodynamics, and Blood Pressure.” Nephrol 3 (February): 1–7. https://doi.org/10.3389/fphar.2012.00018.

Study, S., A. T. Jigjiga, and K. G. Hospital. 2018. C-Reactive Protein.

Thomas, M. C., M. E. Cooper, and P. Zimmet. 2015. “Changing Epidemiology of Type 2 Diabetes Mellitus and Associated Chronic Kidney Disease.” Nature Publishing Group 12 (2): 73–81. https://doi.org/10.1038/nrneph.2015.173.

Toda, A., Y. Ishizaka, M. Tani, and M. Yamakado. 2014. “Hyperuricemia Is a Significant Risk Factor for the Onset of Chronic Kidney Disease.” Nephron Clinical Practice 126 (1): 33–38. https://doi.org/10.1159/000355639.

Tomaiuolo, G. 2014. “Biomechanical Properties of Red Blood Cells in Health and Disease.” Biomicrofluidics 8 (5): 1–19. https://doi.org/10.1063/1.4895755.

US Renal Data System. 2019. “Annual Data Report: Epidemiology of Kidney Disease in the United States.” Michigan Medicine. (n.d.). https://www.uofmhealth.org/news/archive/201911/us-renal-data-system-2019-annual-data-report-epidemiology.

Ulasi, I. I., and C. J. Ijoma. 2010. “The Enormity of Chronic Kidney Disease in Nigeria: The Situation in a Teaching Hospital in Southeast Nigeria.” Journal of Tropical Medicine 2014 (May). https://doi.org/10.1155/2010/501957.

Varga, Z. V. 2012. “Alcohol Misuse and Kidney Injury: Epidemiological Evidence and Potential Mechanisms,” 283–288.

Published

2023-05-11

How to Cite

Seyoum, Fikadu, Belay Zawdie, and Maekel Belay Woldemariam. 2023. “Evaluation of Serum Uric Acid and Its Correlation With Decline in Estimated Glomerular Filtration Rate Among the Chronic Kidney Disease Patients”. Africa Journal of Nursing and Midwifery 25 (1):16 pages. https://doi.org/10.25159/2520-5293/12817.

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Section

Articles
Received 2022-12-21
Accepted 2023-03-15
Published 2023-05-11