Longitudinal uric acid has nonlinear association with kidney failure and mortality in chronic kidney disease

Mathilde Prezelin-Reydit (1) , Christian Combe (2) , Denis Fouque (3) , Luc Frimat (4) , Christian Jacquelinet (5) , Maurice Laville (3) , Ziad Massy (6, 7, 8, 9) , Céline Lange (7, 5) , Carole Ayav (10) , Roberto Pecoits-Filho (11, 12) , Sophie Liabeuf (13, 14) , Bénédicte Stengel (6, 7, 15, 9) , Jérôme Harambat (1) , Karen Leffondré (16, 1) , Natalia Alencar de Pinho , Yves-Edouard Herpe (17, 14) , Christophe Pascal (18) , Joost Schanstra (19, 20) , Oriane Lambert (7) , Marie Metzger (7, 15) , Elodie Speyer

1 BPH - Bordeaux population health
2 BIOTIS - Bioingénierie tissulaire
3 CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition
4 Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Nancy
5 Agence de la biomédecine [Saint-Denis la Plaine]
6 INI-CRCT - Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy]
7 CESP - Centre de recherche en épidémiologie et santé des populations
8 Hôpital Ambroise Paré [AP-HP]
9 Cardiovascular & Renal Clinical Trialists - CRCT - French-Clinical Research Infrastructure Network - F-CRIN [Paris]
10 CIC - Centre d'investigation clinique [Nancy]
11 PUCPR - Pontifícia Universidade Católica do Paraná
12 Arbor Research Collaborative for Health
13 MP3CV - Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517
14 CHU Amiens-Picardie
15 UVSQ - Université de Versailles Saint-Quentin-en-Yvelines
16 ISPED - Institut de Santé Publique, d'Epidémiologie et de Développement
17 Biobanque de Picardie [CHU Amiens - Hôpital Sud]
18 CRDMS - Centre de recherche en Droit et Management des services de santé
19 UPS/Inserm U1297 - I2MC - Institut des Maladies Métaboliques et Casdiovasculaires
20 UT3 - Université Toulouse III - Paul Sabatier

Abstract We investigated the shape of the relationship between longitudinal uric acid (UA) and the hazard of kidney failure and death in chronic kidney disease (CKD) patients, and attempted to identify thresholds associated with increased hazards. We included CKD stage 3–5 patients from the CKD-REIN cohort with one serum UA measurement at cohort entry. We used cause-specific multivariate Cox models including a spline function of current values of UA (cUA), estimated from a separate linear mixed model. We followed 2781 patients (66% men, median age, 69 years) for a median of 3.2 years with a median of five longitudinal UA measures per patient. The hazard of kidney failure increased with increasing cUA, with a plateau between 6 and 10 mg/dl and a sharp increase above 11 mg/dl. The hazard of death had a U-shape relationship with cUA, with a hazard twice higher for 3 or 11 mg/dl, compared to 5 mg/dl. In CKD patients, our results indicate that UA above 10 mg/dl is a strong risk marker for kidney failure and death and that low UA levels below 5 mg/dl are associated with death before kidney failure.

Domaines: Sciences du Vivant [q-bio]; Médecine humaine et pathologie

Mathilde Prezelin-Reydit, Christian Combe, Denis Fouque, Luc Frimat, Christian Jacquelinet, et al.. Longitudinal uric acid has nonlinear association with kidney failure and mortality in chronic kidney disease. Scientific Reports, 2023, 13 (1), pp.3952. ⟨10.1038/s41598-023-30902-7⟩. ⟨hal-04032437⟩