Serum Uric Acid Levels and Nephrosclerosis in a Population-Based Autopsy Study: The Hisayama Study

Kenji Maki; Jun Hata; Satoko Sakata; Emi Oishi; Yoshihiko Furuta; Toshiaki Nakano; Yoshinao Oda; Takanari Kitazono; Toshiharu Ninomiya

doi:10.1159/000521426

Serum Uric Acid Levels and Nephrosclerosis in a Population-Based Autopsy Study: The Hisayama Study

Am J Nephrol. 2022;53(1):69-77. doi: 10.1159/000521426. Epub 2022 Feb 1.

Authors

Kenji Maki^{1

2}, Jun Hata^{3

4

5}, Satoko Sakata^{3

4

5}, Emi Oishi^{3

4}, Yoshihiko Furuta^{3

4}, Toshiaki Nakano^{4

5}, Yoshinao Oda⁶, Takanari Kitazono^{4

5}, Toshiharu Ninomiya^{3

5}

Affiliations

¹ Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan, maki.kenji.737@s.kyushu-u.ac.jp.
² Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan, maki.kenji.737@s.kyushu-u.ac.jp.
³ Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁴ Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁵ Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁶ Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Abstract

Introduction: Information regarding the influence of serum uric acid (SUA) levels on pathological changes in the kidney is limited. In this study, we examined the association between SUA levels and pathological findings of nephrosclerosis in population-based autopsy samples.

Methods: A total of 923 deceased individuals in a Japanese community underwent autopsy examinations between 1974 and 1994. Of these, 547 individuals with available kidney tissues and health examination data within a median of 3 years before death were eligible for the present study. SUA levels were categorized into quintiles (Q1, 107-237; Q2, 238-279; Q3, 280-326; Q4, 327-380; Q5, 381-755 μmol/L). Advanced degrees of glomerular sclerosis, kidney arteriolar hyalinosis, and kidney arteriosclerosis were defined as the 90th percentile or more of a glomerular sclerosis index and an arteriolar hyalinosis index, and the 10th percentile or less of a wall-lumen ratio, respectively. A logistic regression model was used to evaluate odds ratios (ORs) and their 95% confidence intervals (CIs) of SUA levels on each kidney lesion.

Results: Higher SUA levels were significantly associated with higher values of the age- and sex-adjusted glomerular sclerosis index and lower values of the wall-lumen ratio (both p for trend <0.01). Individuals in the Q5 group had a significantly greater likelihood of advanced glomerular sclerosis (OR 7.19, 95% CI 2.42-21.38) and advanced kidney arteriosclerosis (OR 5.28, 95% CI 1.77-15.80) than individuals in the Q1 group after adjusting for potential covariates. There was no evidence of significant associations of SUA levels with either the arteriolar hyalinosis index or the presence of advanced arteriolar hyalinosis.

Conclusions: Elevated SUA levels were significantly associated with advanced glomerular sclerosis and advanced kidney arteriosclerosis, but not with advanced arteriolar hyalinosis in community-based autopsy samples of Japanese.

Keywords: Autopsy; Nephrosclerosis; Population-based study; Uric acid.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Arteriosclerosis* / diagnosis
Arteriosclerosis* / epidemiology
Autopsy
Humans
Nephrosclerosis*
Risk Factors
Sclerosis
Uric Acid

Substances

Uric Acid