Synergetic Association between Anemia and Hyperuricemia on New-Onset Chronic Kidney Disease in a Large Taiwanese Population Follow-Up Study.

Publisher: MDPI Country of Publication: Switzerland NLM ID: 101238455 Publication Model: Electronic Cited Medium: Internet ISSN: 1660-4601 (Electronic) Linking ISSN: 16604601 NLM ISO Abbreviation: Int J Environ Res Public Health Subsets: MEDLINE

Original Publication: Basel : MDPI, c2004-

Hyperuricemia*/complications ; Hyperuricemia*/epidemiology ; Renal Insufficiency, Chronic*/epidemiology ; Renal Insufficiency, Chronic*/etiology ; Anemia*/etiology ; Anemia*/complications; Male ; Female ; Humans ; Follow-Up Studies ; Longitudinal Studies ; Uric Acid ; Glomerular Filtration Rate ; Risk Factors

The incidence of chronic kidney disease (CKD) is increasing worldwide; however, the association between CKD and anemia and hyperuricemia has yet to be clarified. In addition, whether anemia and hyperuricemia only influence renal damage in combination with other comorbidities or whether they are direct causative factors is also controversial. Therefore, the aim of this longitudinal study was to investigate these issues in a large Taiwanese cohort. We enrolled 26,631 participants from the Taiwan Biobank (TWB) after excluding those with CKD at the baseline, all of whom had follow-up data for a median of 4 years. In this study, CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2, incident new-onset CKD was defined as the development of CKD during follow-up, anemia was defined as a hemoglobin level <13 mg/dL in males and <12 mg/dL in females, and hyperuricemia was defined as a serum uric acid (UA) level >7 mg/dL in males and >6 mg/dL in females. The participants were divided into four groups according to whether or not they had anemia and hyperuricemia. Multivariable analysis showed that low hemoglobin (per 1 g/dL; odds ratio [OR], 0.760; p < 0.001) and high serum UA (per 1 mg/dL; OR, 1.444; p < 0.001) in model 1 and anemia (OR, 2.367; p < 0.001) and hyperuricemia (OR, 2.516; p < 0.001) in model 2 were significantly associated with new-onset CKD. Furthermore, compared to the group without anemia or hyperuricemia, the groups with anemia without hyperuricemia (OR, 2.502; p < 0.001), without anemia with hyperuricemia (OR, 2.559; p < 0.001), and with anemia and hyperuricemia (OR, 5.505; p < 0.001) were significantly associated with new-onset CKD. There was a significant interaction between hemoglobin and serum UA and new-onset CKD (p < 0.001). In conclusion, we found that anemia and hyperuricemia were associated with new-onset CKD, respectively, and also had a synergetic effect on new-onset CKD.

Nephron Physiol. 2008;108(4):p69-78. (PMID: 18434753)
Pharmaceuticals (Basel). 2018 Oct 11;11(4):. (PMID: 30314359)
Diabetes Care. 2008 Feb;31(2):361-2. (PMID: 17977935)
J Am Soc Nephrol. 2007 Jan;18(1):287-92. (PMID: 17167112)
J Am Soc Nephrol. 2008 Jun;19(6):1204-11. (PMID: 18337481)
JACC Basic Transl Sci. 2020 Apr 27;5(4):398-412. (PMID: 32368697)
Nephron Exp Nephrol. 2004;98(1):e8-12. (PMID: 15361693)
JAMA. 2019 Oct 1;322(13):1294-1304. (PMID: 31573641)
Emerg Med Pract. 2013 Nov;15(11):1-15; quiz 15-6. (PMID: 24716235)
Hypertens Res. 2001 Nov;24(6):691-7. (PMID: 11768729)
Kidney Int. 2003 Apr;63(4):1499-507. (PMID: 12631367)
J Hypertens. 2008 Feb;26(2):269-75. (PMID: 18192841)
Clin Exp Nephrol. 2015 Feb;19(1):54-64. (PMID: 24821288)
Kidney Int. 2021 Dec;100(6):1160-1162. (PMID: 34802554)
Am J Kidney Dis. 2015 Feb;65(2):294-302. (PMID: 25301104)
Am J Physiol Renal Physiol. 2002 Jun;282(6):F991-7. (PMID: 11997315)
Hypertension. 2006 Dec;48(6):1037-42. (PMID: 17060502)
Hum Mol Genet. 2016 Dec 15;25(24):5321-5331. (PMID: 27798100)
J Law Med Ethics. 2015 Winter;43(4):816-26. (PMID: 26711420)
J Am Soc Nephrol. 2020 Dec;31(12):2773-2792. (PMID: 32938648)
J Clin Epidemiol. 1996 Aug;49(8):907-16. (PMID: 8699212)
Int J Cardiol. 2016 Jun 15;213:8-14. (PMID: 26316329)
Ann Intern Med. 1999 Mar 16;130(6):461-70. (PMID: 10075613)
Am J Nephrol. 2011;33(4):298-304. (PMID: 21389694)
Am J Cardiol. 2007 Apr 15;99(8):1137-42. (PMID: 17437743)
Kidney Int. 2021 Dec;100(6):1227-1239. (PMID: 34537228)
Am J Physiol Renal Physiol. 2008 Oct;295(4):F1134-41. (PMID: 18701632)
Curr Opin Nephrol Hypertens. 2003 Nov;12(6):593-8. (PMID: 14564195)
J Formos Med Assoc. 2022 Feb;121 Suppl 1:S5-S11. (PMID: 35074236)
Stroke. 1998 Mar;29(3):635-9. (PMID: 9506605)
Hypertens Res. 2014 Aug;37(8):785-9. (PMID: 24671018)
Kidney Int Suppl. 2000 Apr;75:S22-6. (PMID: 10828757)
Sci Rep. 2021 Jun 8;11(1):12080. (PMID: 34103622)
J Am Soc Nephrol. 2008 Dec;19(12):2407-13. (PMID: 18799720)
Sci Rep. 2019 Dec 13;9(1):19067. (PMID: 31836793)
Semin Nephrol. 2004 Sep;24(5):469-73. (PMID: 15490413)
Curr Hypertens Rep. 2020 Oct 31;22(12):102. (PMID: 33128170)
J Hypertens. 2014 Jan;32(1):57-64. (PMID: 24309486)
Kidney Blood Press Res. 2005;28(5-6):295-301. (PMID: 16534224)

Keywords: Taiwan Biobank; anemia; follow-up; hyperuricemia; new-onset chronic kidney disease; synergetic effect

268B43MJ25 (Uric Acid)

Date Created: 20230121 Date Completed: 20230124 Latest Revision: 20231118

20240829

PMC9859151

10.3390/ijerph20021421

36674173