Prevalence and risk factors of hyperuricemia in patients with chronic kidney disease

Objective To explore the prevalence and risk factors of hyperuricemia in patients with chronic kidney disease(CKD) hospitalized in Shanghai East Hospital and Ji'an Hospital of Shanghai East Hospital, and to provide clinical reference for the prevention and treatment of hyperuricemia in CKD patients. Methods Total 436 CKD patients hospitalized in East Hospital Affiliated to Tongji University(Shanghai) and Shanghai East Hospital Ji'an Hospital(Ji'an, Jiangxi) from January 1, 2017 to July 31, 2019 were divided into CKD 1 to 5 groups according to K/DOQI guidelines. The prevalence of hyperuricemia and related risk factors in different CKD stages were analyzed. Results The prevalence of hyperuricemia in patients with different CKD stages is different, and the difference was statistically significant(P<0.001). Multivariate logistic regression analysis showed that diastolic blood pressure(OR=1.025, 95% CI: 1.005-1.044, P=0.012) was a risk factor for hyperuricemia, while ACEI/ARB(OR=0.536, 95% CI: 0.335-0.859, P=0.009) and estimated glomerular filtration rate(eGFR, OR=0.988, 95% CI: 0.980-0.997, P=0.005) were protective factors for hyperuricemia. Compared with the CKD 1 stage group, the ORs of hyperuricemia of the CKD 4 stage group was the highest, 4.385(OR=4.385, 95% CI: 1.655-11.621, P=0.003). Conclusion Among CKD patients, the increase of diastolic blood pressure is the risk factor of hyperuricemia, while taking ACEI/ARB drugs and higher glomerular filtration rate are the protective factors for hyperuricemia. The progress of CKD is significantly correlated with hyperuricemia, suggesting that controlling blood pressure and protection of glomerular filtration rate in patients with CKD are of great significance in the prevention and treatment of hyperuricemia. Controlling the level of serum uric acid may benefit to improve the residual renal function and the prognosis of CKD.