Association of uric acid with change in kidney function in healthy normotensive individuals

Am J Kidney Dis. 2010 Aug;56(2):264-72. doi: 10.1053/j.ajkd.2010.01.019. Epub 2010 Apr 10.


Background: Despite recent evidence, the role of uric acid as a causal factor in the pathogenesis and progression of kidney disease remains controversial, partly because of the inclusion in epidemiologic studies of patients with hypertension, diabetes, and/or proteinuria.

Study design: Prospective observational cohort.

Setting & participants: 900 healthy normotensive adult blood donors (153 women, 747 men) evaluated at baseline and after 5 years.

Predictor: Serum uric acid level.

Outcomes: Decrease in estimated glomerular filtration rate (eGFR) >10 mL/min/1.73 m(2), computed using the Modification of Diet in Renal Disease (MDRD) Study equation, with secondary analyses examining similar decreases using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Cockcroft-Gault equations.

Results: During a median follow-up of 59 months, eGFR decreased from 97 +/- 16 to 88 +/- 14 mL/min/1.73 m(2). Higher serum uric acid levels were associated with a greater likelihood of eGFR decrease in both women and men (HR, 1.13 [95% CI, 1.04-1.39] per each 1-mg/dL increase in uric acid level); in multivariable analyses adjusting for age, sex, body mass index, blood glucose level, total cholesterol level, mean blood pressure, urine albumin-creatinine ratio, and serum triglyceride level, the association remained highly significant (HR, 1.28 [95% CI, 1.12-1.48]). Results were similar using different estimating equations and when the association was examined in sex-specific subgroups.

Limitations: Analyses were based on a single baseline uric acid measurement. Women are underrepresented.

Conclusions: In healthy normotensive individuals, serum uric acid level is an independent risk factor for decreased kidney function.

MeSH terms

  • Adult
  • Aged
  • Creatinine / blood
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney / physiology*
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Insufficiency, Chronic / blood*
  • Renal Insufficiency, Chronic / physiopathology
  • Risk Factors
  • Uric Acid / blood*


  • Uric Acid
  • Creatinine