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Randomized Controlled Trial
. 2020 May;24(5):420-426.
doi: 10.1007/s10157-019-01840-4. Epub 2019 Dec 26.

The association between uric acid levels and renal function of CKD patients with hyperlipidemia: a sub-analysis of the ASUCA trial

Yoshihiro Kuwabara  1 , Shinji Yasuno  2 , Masato Kasahara  3 , Kenji Ueshima  4 , Kazuwa Nakao  5
Affiliations
Randomized Controlled Trial

The association between uric acid levels and renal function of CKD patients with hyperlipidemia: a sub-analysis of the ASUCA trial

Yoshihiro Kuwabara et al. Clin Exp Nephrol. 2020 May.

Abstract

Background: The influence of uric acid (UA) on renal function and the significance of UA-lowering therapy are unclear. The purpose of the sub-analysis of the Assessment of Clinical Usefulness in chronic kidney disease patients with Atorvastatin (ASUCA) trial was to evaluate the influence of serum UA levels on renal function in Japanese chronic kidney disease patients with hyperlipidemia.

Methods: Of 344 participants in the ASUCA trial, 279 participants whose UA levels at both baseline and 24 months were available were included. Based on UA level at baseline or mean UA level during the trial period, they were divided into four groups: < 5.0, 5.0-6.0, 6.0-7.0, or ≥ 7.0 mg/dL, irrespective of allocation. Changes in the estimated glomerular filtration rate (eGFR) after 24 months were compared among the groups in relation to baseline or mean UA levels.

Results: For baseline UA levels (< 5.0, 5.0-6.0, 6.0-7.0, or ≥ 7.0 mg/dL), the change in eGFR after 24 months was - 1.32 ± 10.3, - 1.74 ± 8.94, - 2.53 ± 7.34, and - 3.51 ± 9.10 mL/min/1.73 m2, respectively. A negative correlation between changes in eGFR after 24 months and baseline UA level was observed with adjustment for confounding factors. The relationship between changes in eGFR and mean UA levels during trial period showed a similar trend.

Conclusion: In CKD patients with dyslipidemia, hyperuricemia was an independent risk factor for CKD progression. An ongoing clinical trial (TARGET-UA, UMIN-ID 000,026,741) may reveal the significance of strict UA-lowering therapy in CKD patients.

Keywords: Chronic kidney disease; Hyperuricemia; Renal function; Uric acid.

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Conflict of interest statement

M. Kasahara report has received research funding and Honoraria from Daiichi-Sankyo Pharmaceuticals and Fuji-Yakuhin Pharmaceuticals. None of the other authors have any conflicts of interests to disclose.

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