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High uric acid level is a risk factor for progression of IgA nephropathy with chronic kidney disease stage G3a

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Abstract

Background

High uric acid level is a known risk factor for deterioration of renal function in chronic kidney disease (CKD), but its influence on the progression of IgA nephropathy (IgAN) remains unclear.

Methods

Adult IgAN patients (n = 611) were classified according to CKD stage. Renal survival rates and clinical and histological findings were compared between patients with high (H-UA) and normal (N-UA) uric acid levels in different CKD stages.

Results

The proportion of patients with H-UA increased significantly with increasing CKD stage (stage G1, 12.3 %; stage G2, 19.0 %; stage G3a, 43.7 %; stage G3b–4, 69.0 %; P < 0.001). The 30-year renal survival rate was similar in patients with H-UA and N-UA in CKD stages G1, G2, and G3b–4, but was significantly lower in patients with H-UA than with N-UA in CKD stage G3a (24.7 vs. 51.9 %; P = 0.0205). The clinical findings were similar in patients with H-UA and N-UA, but the interval from onset to biopsy differed between groups. The proportion of patients with global sclerosis was significantly higher in patients with H-UA than with N-UA in CKD stage G3a (33.3 vs. 11.4 %; P = 0.0005), but the Oxford classifications were similar between groups. Multivariate Cox regression analysis identified H-UA (HR 1.36, 95 % CI 1.07–1.72, P = 0.011) and a large amount of proteinuria (HR 1.38, 95 % CI 1.09–1.74, P = 0.0084) as independent predictors of end-stage renal disease.

Conclusions

H-UA induced global glomerular sclerosis and accelerated the progression of IgAN in CKD stage G3a.

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All authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Medicine, Kidney Center, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Takahito Moriyama, Mitsuyo Itabashi, Takashi Takei, Hiroshi Kataoka, Masayo Sato, Ari Shimizu, Yuko Iwabuchi, Miki Nishida, Keiko Uchida & Kosaku Nitta

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  1. Takahito Moriyama
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  2. Mitsuyo Itabashi
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  3. Takashi Takei
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  4. Hiroshi Kataoka
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  5. Masayo Sato
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  6. Ari Shimizu
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  7. Yuko Iwabuchi
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  8. Miki Nishida
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  9. Keiko Uchida
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  10. Kosaku Nitta
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Correspondence to Takahito Moriyama.

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Moriyama, T., Itabashi, M., Takei, T. et al. High uric acid level is a risk factor for progression of IgA nephropathy with chronic kidney disease stage G3a. J Nephrol 28, 451–456 (2015). https://doi.org/10.1007/s40620-014-0154-0

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  • DOI: https://doi.org/10.1007/s40620-014-0154-0

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