The influence of serum uric acid on renal function in patients with calcium or uric acid stone: A population-based analysis

• Published in: PloS one Vol. 12; no. 7; p. e0182136
• Main Authors: Tanaka, Yoshimi, Hatakeyama, Shingo, Tanaka, Toshikazu, Yamamoto, Hayato, Narita, Takuma, Hamano, Itsuto, Matsumoto, Teppei, Soma, Osamu, Okamoto, Teppei, Tobisawa, Yuki, Yoneyama, Tohru, Yoneyama, Takahiro, Hashimoto, Yasuhiro, Koie, Takuya, Takahashi, Ippei, Nakaji, Shigeyuki, Terayama, Yuriko, Funyu, Tomihisa, Ohyama, Chikara
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 31.07.2017; Public Library of Science (PLoS)
• Subjects: Acids; Aged; Albumin; Biology and Life Sciences; Body mass; Body mass index; Calcification; Calcium; Calcium oxalate; Calcium phosphates; Calcium Phosphates - analysis; Cardiovascular diseases; Care and treatment; Clinical trials; Developmental stages; Diabetes; Diagnosis; Ethics; Female; Health promotion; Hemoglobin; Humans; Hypertension; Hyperuricemia; Impairment; Kidney - physiopathology; Kidney diseases; Kidney stones; Kidney transplantation; Lithiasis; Male; Medicine; Medicine and Health Sciences; Metabolic syndrome; Middle Aged; Nephrology; Oxalic acid; Patients; Phosphate; Phosphates; Physical Sciences; Physiological aspects; Regression analysis; Renal function; Research and Analysis Methods; Risk factors; Serum albumin; Social Sciences; Stone; Subgroups; Transplants & implants; University graduates; Uric acid; Uric Acid - analysis; Uric Acid - blood; Urinary Calculi - blood; Urinary Calculi - chemistry; Urinary Calculi - physiopathology; Urine; Urolithiasis; Urology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0182136

To determine the influence of serum uric acid (UA) levels on renal impairment in patients with UA stone. We retrospectively analyzed 463 patients with calcium oxalate and/or calcium phosphate stones (CaOx/CaP), and 139 patients with UA stones. The subjects were divided into the serum UA-high (UA ≥ 7.0 mg/dL) or the UA-low group (UA < 7.0 mg/dL). The control group comprised 3082 community-dwelling individuals that were pair-matched according to age, sex, body mass index, comorbidities, hemoglobin, serum albumin, and serum UA using propensity score matching. We compared renal function between controls and patients with UA stone (analysis 1), and between patients with CaOx/CaP and with UA stone (analysis 2). Logistic regression analysis was used to evaluate the impact of the hyperuricemia on the development of stage 3 and 3B chronic kidney disease (CKD) (analysis 3). The renal function was significantly associated with serum UA levels in the controls and patients with CaOx/CaP and UA stones. In pair-matched subgroups, patients with UA stone had significantly lower renal function than the control subjects (analysis 1) and patients with CaOx/CaP stones (analysis 2) regardless of hyperuricemia. Multivariate logistic regression analysis revealed that patients with UA stone, CaOx/CaP, hyperuricemia, presence of cardiovascular disease, higher body mass index, older age and lower hemoglobin had significantly higher risk of stage 3 and 3B CKD (analysis 3). Patients with UA stones had significantly worse renal function than controls and CaOx/CaP patients regardless of hyperuricemia. Urolithiasis (CaOx/CaP and UA stone) and hyperuricemia had an association with impaired renal function. Our findings encourage clinicians to initiate intensive treatment and education approaches in patients with urolithiasis and/or hyperuricemia in order to prevent the progression of renal impairment.