Association between hyperuricemia and progression of chronic kidney disease: a longitudinal study

Original Article

Abstract

Background: Various factors some of which can be changed, play a role in the progression of chronic kidney disease. There is new evidence to show that higher levels of uric acid may fasten renal function degradation by damaging blood vessels, increasing inflammation in the kidneys, and interacting with oxidative reactions in the body.

 Objectives: To look at whether there is a link between high uric acid and how kidney disease gets worse in adults and to see if having higher levels of uric acid on its own can predict changes in kidney function over time.

 Methods: A longitudinal cohort study was done at the Nephrology Department of Nephrology MTI,LRH Peshawar from January 2021 to December 2023. Adult patients with CKD stages 2–4 was included and watched for 24 months. Serum uric acid and estimated glomerular filtration rate (eGFR) were checked and recorded at the start of the study and again later. CKD progression was considered to happen if a person’s kidney function dropped by 25% or if their blood test score showed the disease had gotten worse. Data were analyzed using SPSS v24.0.

 Results: 152 patients, and their mean age was 58.4 years, with a standard deviation of 13.2. 61% were male. Out of the patients studied, 52% (78 patients) had hyperuricemia. In hyperuricemia patients, progression of CKD was seen in 42.3% of cases, whereas only 24.7% showed progression among normouricemic patients (p=0.01). The eGFR rate of drop was higher in the hyperuricemia group over the 24-month period (12.8 ± 6.3 vs. 7.4 ± 4.9 mL/min/1.73 m²). p=0.002). Having hyperuricemia increased the risk of CKD progression (HR: 1.76, 95% CI: 1.18–2.84, p=0.004).

 Conclusion: The findings of this study suggest that hyperuricemia is strongly linked to the advanced stages of CKD. People with high serum uric acid were more likely to experience kidney function decline and more rapid development of the disease as time passed. This research points out that CKD patients should have their blood uric acid levels monitored often. Also, managing elevated uric acid may help keep kidney function decline at bay.