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Hyperuricemia is associated with decreased renal function and occurrence of end-stage renal disease in patients with microscopic polyangiitis and granulomatosis with polyangiitis: a retrospective study

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Abstract

Current evidence suggests that high uric acid levels are associated with accelerated renal damage. However, the clinical impact of serum uric acid level on patients with microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) is unknown. We aimed to evaluate the impact of hyperuricemia on such patients. A retrospective study was performed to obtain patients’ demographic, clinical, and laboratory data from when they were diagnosed with MPA and GPA. Multivariable logistic regression and Cox hazard model analyses were performed to evaluate factors associated with hyperuricemia at diagnosis and predictive factors of end-stage renal disease (ESRD) development. Among 156 patients, 35 (22.4%) had hyperuricemia at baseline. Hyperuricemic patients had renal manifestation and impaired renal function more frequently than non-hyperuricemic patients. Logistic regression analysis revealed that serum creatinine was significantly associated with hyperuricemia at diagnosis [odds ratio 1.995; 95% confidence interval (CI), 1.503–2.648; P < 0.001]. Cox hazard model analysis revealed that body mass index and serum creatinine were significantly associated with ESRD when all variables were included, but hyperuricemia was independently associated with ESRD [hazard ratio (HR), 3.799; 95% CI 1.719–8.222; P < 0.001) when serum creatinine was excluded. Additionally, in a subgroup analysis of patients with decreased glomerular filtration rates (GFRs), serum uric acid was the sole predictor of ESRD (HR, 1.243; 95% CI 1.048–1.475; P = 0.013). Hyperuricemia is associated with renal damage and ESRD occurrence in MPA and GPA patients. Serum uric acid level is associated with ESRD occurrence in patients with decreased GFRs.

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Acknowledgements

This study was supported for English editing service from Editage.

Funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) and funded by the Ministry of Education (2017R1D1A1B03029050) and a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (HI14C1324).

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  1. Hyeok Chan Kwon and Sung Soo Ahn contributed equally to this work.

Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun–gu, Seoul, 03722, Republic of Korea

    Hyeok Chan Kwon, Sung Soo Ahn, Byung-Woo Yoo, Juyoung Yoo, Seung Min Jung, Jason Jungsik Song, Yong-Beom Park & Sang-Won Lee

  2. Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea

    Jason Jungsik Song, Yong-Beom Park & Sang-Won Lee

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Contributions

Conceptualization: HCK, SSA and SWL. Data curation: SSA, BWY and JY. Formal analysis: JY and SMJ. Methodology: SSA, JJS and SWL. Project administration: HCK and SSA. Supervision: YBP and SWL. Writing—original draft: HCK and SWL. Writing—review and editing: SSA, BWY, JY, SMJ, JJS, YBP and SWL. All authors take full responsibility for the integrity of the study and final manuscript.

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Correspondence to Sang-Won Lee.

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This study was performed in accordance with the principles set by the Declaration of Helsinki, and was approved by the Institutional Review Board (IRB) of Severance Hospital (IRB number: 4-2017-0673).

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Kwon, H.C., Ahn, S.S., Yoo, BW. et al. Hyperuricemia is associated with decreased renal function and occurrence of end-stage renal disease in patients with microscopic polyangiitis and granulomatosis with polyangiitis: a retrospective study. Rheumatol Int 40, 1089–1099 (2020). https://doi.org/10.1007/s00296-020-04579-4

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