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Association between Serum Uric Acid Level and ESRD or Death in a Korean Population
BACKGROUND: Serum uric acid (SUA) is recognized as a risk factor for chronic kidney disease (CKD) and mortality. However, there is controversy as to whether a high or low level of SUA is related to the risk of CKD progression or death, and whether it differs between males and females. METHODS: We in...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Korean Academy of Medical Sciences
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7371451/ https://www.ncbi.nlm.nih.gov/pubmed/32686371 http://dx.doi.org/10.3346/jkms.2020.35.e254 |
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author | Kim, Kipyo Go, Suryeong Son, Hyung Eun Ryu, Ji Young Lee, Hajeong Heo, Nam Ju Chin, Ho Jun Park, Jung Hwan |
author_facet | Kim, Kipyo Go, Suryeong Son, Hyung Eun Ryu, Ji Young Lee, Hajeong Heo, Nam Ju Chin, Ho Jun Park, Jung Hwan |
author_sort | Kim, Kipyo |
collection | PubMed |
description | BACKGROUND: Serum uric acid (SUA) is recognized as a risk factor for chronic kidney disease (CKD) and mortality. However, there is controversy as to whether a high or low level of SUA is related to the risk of CKD progression or death, and whether it differs between males and females. METHODS: We included 143,762 adults who underwent voluntary health screening between 1995 and 2009 in Korea. For each sex, we divided participants into sex-specific quintiles according to SUA levels and compared end-stage renal disease (ESRD) incidence and mortality between the groups with low and high SUA levels and those with middle SUA levels. Sex-specific Cox proportional hazard analyses were performed for ESRD and all-cause mortality. RESULTS: Among the 143,762 participants, 0.2% (n = 272) developed ESRD. The hazard ratio (HR) of ESRD was higher in the highest (adjusted HR, 2.13; 95% confidence interval [CI], 1.18–3.84) and lowest (adjusted HR, 1.90; 95% CI, 1.02–3.51) SUA quintiles than in the middle SUA quintile in males and the highest SUA quintile in females (adjusted HR, 2.31; 95% CI, 1.10–4.84). Four-point three percent (n = 6,215) of participants died during a mean follow-up period of 157 months. The hazard ratio (HR) of all-cause mortality was higher in the highest SUA quintile than in the middle SUA quintile in males (adjusted HR, 1.15; 95% CI, 1.03–1.28) and females (adjusted HR, 1.17; 95% CI, 1.01–1.35). CONCLUSION: Elevated levels of SUA are associated with increased risk for ESRD and all-cause mortality in both sexes. Low levels of SUA might be related to ESRD and death only in males, showing U-shaped associations. Our findings suggest sex-specific associations between SUA levels and ESRD development and mortality. |
format | Online Article Text |
id | pubmed-7371451 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The Korean Academy of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-73714512020-07-26 Association between Serum Uric Acid Level and ESRD or Death in a Korean Population Kim, Kipyo Go, Suryeong Son, Hyung Eun Ryu, Ji Young Lee, Hajeong Heo, Nam Ju Chin, Ho Jun Park, Jung Hwan J Korean Med Sci Original Article BACKGROUND: Serum uric acid (SUA) is recognized as a risk factor for chronic kidney disease (CKD) and mortality. However, there is controversy as to whether a high or low level of SUA is related to the risk of CKD progression or death, and whether it differs between males and females. METHODS: We included 143,762 adults who underwent voluntary health screening between 1995 and 2009 in Korea. For each sex, we divided participants into sex-specific quintiles according to SUA levels and compared end-stage renal disease (ESRD) incidence and mortality between the groups with low and high SUA levels and those with middle SUA levels. Sex-specific Cox proportional hazard analyses were performed for ESRD and all-cause mortality. RESULTS: Among the 143,762 participants, 0.2% (n = 272) developed ESRD. The hazard ratio (HR) of ESRD was higher in the highest (adjusted HR, 2.13; 95% confidence interval [CI], 1.18–3.84) and lowest (adjusted HR, 1.90; 95% CI, 1.02–3.51) SUA quintiles than in the middle SUA quintile in males and the highest SUA quintile in females (adjusted HR, 2.31; 95% CI, 1.10–4.84). Four-point three percent (n = 6,215) of participants died during a mean follow-up period of 157 months. The hazard ratio (HR) of all-cause mortality was higher in the highest SUA quintile than in the middle SUA quintile in males (adjusted HR, 1.15; 95% CI, 1.03–1.28) and females (adjusted HR, 1.17; 95% CI, 1.01–1.35). CONCLUSION: Elevated levels of SUA are associated with increased risk for ESRD and all-cause mortality in both sexes. Low levels of SUA might be related to ESRD and death only in males, showing U-shaped associations. Our findings suggest sex-specific associations between SUA levels and ESRD development and mortality. The Korean Academy of Medical Sciences 2020-07-08 /pmc/articles/PMC7371451/ /pubmed/32686371 http://dx.doi.org/10.3346/jkms.2020.35.e254 Text en © 2020 The Korean Academy of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Kipyo Go, Suryeong Son, Hyung Eun Ryu, Ji Young Lee, Hajeong Heo, Nam Ju Chin, Ho Jun Park, Jung Hwan Association between Serum Uric Acid Level and ESRD or Death in a Korean Population |
title | Association between Serum Uric Acid Level and ESRD or Death in a Korean Population |
title_full | Association between Serum Uric Acid Level and ESRD or Death in a Korean Population |
title_fullStr | Association between Serum Uric Acid Level and ESRD or Death in a Korean Population |
title_full_unstemmed | Association between Serum Uric Acid Level and ESRD or Death in a Korean Population |
title_short | Association between Serum Uric Acid Level and ESRD or Death in a Korean Population |
title_sort | association between serum uric acid level and esrd or death in a korean population |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7371451/ https://www.ncbi.nlm.nih.gov/pubmed/32686371 http://dx.doi.org/10.3346/jkms.2020.35.e254 |
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