Correlation between serum uric acid and incident chronic kidney disease in middle-aged and elderly Chinese population and gender differences

MIN Qing, ZHANG Han, SHEN Zi-yan, LYU Shi-qi, ZHU Cheng, ZHANG Xiao-yan, DING Xiao-qiang

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Fudan University Journal of Medical Sciences ›› 2025, Vol. 52 ›› Issue (03) : 317-325. DOI: 10.3969/j.issn.1672-8467.2025.03.001
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Correlation between serum uric acid and incident chronic kidney disease in middle-aged and elderly Chinese population and gender differences

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Abstract

Objective To investigate the correlation between serum uric acid (SUA) levels and incident chronic kidney disease (CKD) in middle-aged and elderly Chinese population and gender differences. Methods Based on the longitudinal survey data of China Health and Retirement Longitudinal Study from 2011 to 2015, the CKD-Epidemiology Collaboration cystatin C formula was used to estimate the glomerular filtration rate (eGFR), and 4 119 participants with normal renal function (eGFR≥60 mL·min-1·1.72 m-2) at baseline were included. Incident CKD was defined as eGFR<60 mL·min-1·1.72 m-2 at the follow-up in 2015. Logistic regression analysis was used to analysis the association of SUA levels at baseline and incident CKD among different genders. Restricted cubic spline analysis was used to analyze the dose-response relationship. Results After 4-year follow-up, 127 participants developed incident CKD, including 57 males and 70 females. Multivariate Logistic regression analysis showed that elevated SUA levels were independently associated with the risk of incident CKD (OR=1.532,P<0.001). For each 1 mg/dL increase in SUA, the risk of incident CKD increased by 33.6% in males (OR=1.336,P=0.012) and 77.5% in females (OR=1.755,P<0.001). Restricted cubic spline analysis showed a linear positive correlation between SUA levels and incident CKD in both males and females. Participants were divided into four groups according to SUA quartiles (Q1-Q4). Multivariate Logistic regression analysis indicated a significant increase in the risk of incident CKD in Q3 group (3.75 mg/dL<SUA≤4.43 mg/dL) and Q4 group (SUA>4.43 mg/dL) compared with Q1 group in females (Q3 group: OR=2.571,P=0.045;Q4 group: OR=3.666,P=0.005). Conclusion SUA is an independent risk factor for incident CKD in the middle-aged and elderly population. In females, serum uric acid levels exceeding 3.75 mg/dL are associated with an increased risk of incident CKD.

Key words

serum uric acid (SUA) / chronic kidney disease (CKD) / gender differences / middle-aged and elderly population

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MIN Qing , ZHANG Han , SHEN Zi-yan , et al . Correlation between serum uric acid and incident chronic kidney disease in middle-aged and elderly Chinese population and gender differences. Fudan University Journal of Medical Sciences. 2025, 52(03): 317-325 https://doi.org/10.3969/j.issn.1672-8467.2025.03.001

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闵青 数据整理和分析,论文撰写。张函 研究构思,数据分析,论文修订。沈子妍,吕诗琦,朱诚 数据整理和分析,文献调研。章晓燕 研究构思,论文指导。丁小强 研究设计,论文修订。

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Federation of Nephrology Project of Shanghai Hospital Development Center(SHDC2202230)

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