Uric acid and incident chronic kidney disease in dyslipidemic individuals

Background: Elevated uric acid (UA) is a recognized risk factor for chronic kidney disease (CKD). This study aimed to investigate whether this association exists in dyslipidemic patients receiving multifactorial treatment. Methods: An observational study conducted in Greece including 1,269 dyslipidemic individuals followed-up in a lipid clinic for >= 3 years. Estimated glomerular filtration rate (eGFR) was calculated by CKD-EPI equation and CKD was defined as <= 60mL/min/1.73 m(2). The correlation was assessed between UA levels and the CKD risk after adjusting for potential confounding factors, after defining the following UA quartiles: Q1: <4, Q2: 4-5, Q3: 5-6, and Q4: >6mg/dL. Results: After excluding patients with baseline eGFR <60mL/min/1.73 m(2), gout and those taking UA-lowering drugs, 1,095 individuals were eligible; of those, 91% and 69% were treated with statins and anti-hypertensive drugs, respectively. During their follow-up (6 years; IQR=4-10), 11.9% of the subjects developed CKD, whereas the median annual eGFR decline was 0.69mL/min/1.73 m(2) (IQR=0.45-2.33). Multivariate analysis showed that baseline UA levels (HR=1.26; 95% CI=1.09-1.45, p=.001), female gender (HR=1.74; 95% CI=1.14-2.65, p=.01), age (HR=1.10; 95% CI=1.07-1.12, p<.001), diabetes (HR=1.67; 95% CI=1.05-2.65, p=.03), cardiovascular disease (HR=1.62; 95% CI=1.02-2.58, p=.04), decreased baseline renal function (eGFR <90mL/min/1.73 m(2)) (HR=2.38; 95% CI=1.14-4.81, p=.02), and low-density lipoprotein cholesterol reduction (HR=0.995; 95% CI=0.991-0.998, p=.01) were associated with incident CKD. Additionally, patients with UA >= 6mg/dL exhibited a higher risk of incident CKD compared with those in the lowest UA quartile (HR=2.01; 95% CI=1.11-3.65, p=.02). Conclusion: Higher UA levels are correlated with a higher risk of incident CKD in dyslipidemic individuals taking multifactorial treatment.