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Serum uric acid is an independent predictor of renal outcomes in patients with idiopathic membranous nephropathy

  • Nephrology - Original Paper
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Abstract

Purpose

Accumulating evidence suggests that a relationship exists between serum uric acid (UA) and the progression of chronic kidney disease (CKD), but information regarding idiopathic membranous nephropathy (IMN) is limited.

Methods

Patients with renal biopsy-confirmed diagnosis of IMN between 2009 and 2017 were identified. The demographic and clinical data recorded at the time of renal biopsy were considered the baseline values. The included cases were separated into three groups based on tertiles of the baseline serum UA level, and the relationship between serum UA and poor renal outcome was investigated by receiver operating characteristic (ROC) and time-event analyses. The primary endpoint was poor renal outcome, which was defined as a decrease in the estimated glomerular filtration rate to 50% of the baseline level or progression to end-stage renal disease during the follow-up.

Results

Of 989 cases, 572 eligible patients were included. During a median of 18 months of follow-up, 45 (7.9%) patients progressed to the primary endpoint. Both baseline serum UA and time-averaged UA levels could be used for discrimination of renal outcomes, but the difference was not significant (p value = 0.6). Our Cox regression analysis further demonstrated that baseline serum UA was an independent predictor of poor renal outcome in IMN patients, and subgroup analysis revealed a gender difference in the predictive effect of serum UA.

Conclusions

Our study demonstrated that baseline serum UA was an independent predictor of poor renal outcome in patients with IMN, and a gender difference in the predictive effect was observed in our cohort.

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Abbreviations

UA:

Uric acid

CI:

Confidence interval

HR:

Hazard ratio

MN:

Membranous nephropathy

ESRD:

End-stage renal disease

CKD:

Chronic kidney disease

BP:

Blood pressure

eGFR:

Estimated glomerular filtration rate

SD:

Standard deviation

Scr:

Serum creatinine

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

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Acknowledgements

The authors would like to thank their colleagues at the Department of Nephrology, the First and Second Affiliated Hospitals of Wenzhou Medical University for their support and assistance during the study period.

Funding

This study was supported by the Wenzhou Municipal Science and Technology Bureau under Grant Y20170300 to Min Pan and the Natural Science Foundation of Zhejiang Province under Grant LY14H050006 to Fan Lin.

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Authors and Affiliations

  1. Department of Nephrology, The First Affiliated Hospital of Soochow University, 88 Shizi St., Suzhou, 215006, Jiangsu, People’s Republic of China

    Ji Zhang, JianNa Zhang, XiaoHan You & GuoYuan Lu

  2. Department of Nephrology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China

    Min Pan

  3. Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China

    Ji Zhang, JianNa Zhang, XiaoHan You, Dou Li & Fan Lin

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  1. Ji Zhang
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Contributions

All authors contributed significant intellectual content to this manuscript as follows: principal investigators, conceived and designed the study: ZJ, PM, and LGY; assessed the study, extracted data, and performed statistical analyses: ZJ, ZJN, YXH, and LD; drafted the manuscript: ZJ; performed a critical review of the manuscript: LF and LGY. All authors have read the manuscript and approved the final version.

Corresponding author

Correspondence to GuoYuan Lu.

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Conflict of interest

The authors have no competing interests to declare.

Ethical approval

The procedure was approved by the Ethics Committee of the First Affiliated Hospital of Wenzhou Medical University.

Informed consent

This study was performed after obtaining written informed consent from all patients.

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Zhang, J., Pan, M., Zhang, J. et al. Serum uric acid is an independent predictor of renal outcomes in patients with idiopathic membranous nephropathy. Int Urol Nephrol 51, 1797–1804 (2019). https://doi.org/10.1007/s11255-019-02254-7

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  • DOI: https://doi.org/10.1007/s11255-019-02254-7

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