Increased serum uric acid-to-urinary urate excretion ratio with the kidney function decline in male CKD patients without diabetes: a retrospective cohort study.

BACKGROUND: The relationship between uric acid and chronic kidney disease (CKD) progression remains unclear. To study the association between the serum uric acid-to-24-hour-urinary urate excretion ratio (SUER) and kidney events in patients experiencing chronic kidney disease (CKD) progression. METHODS: A retrospective cohort study involving 165 CKD patients with estimated glomerular filtration rates (eGFRs) between 15 and 150 mL/min/1.73 m2 was conducted at Huadong Hospital, Fudan University (Shanghai, P. R. China). The exposure variable was the SUER, whereas the outcome was a renal endpoint event, defined as a 50% decrease in eGFR from baseline, initiation of renal replacement therapy, or death during follow-up. Both univariate and multivariate logistic regression analyses were performed in the entire cohort and in male subgroups with or without diabetes mellitus. Forest plots were drawn to visualize the odds ratios (ORs) derived from multivariate regression analysis, and receiver operating characteristic (ROC) curves were constructed. And we divided the male non-diabetic population into low UACR group and high UACR group based on the median UACR, and conducted a univariate analysis of the differential variables. P < 0.05 was considered to indicate statistical significance. RESULTS: The general population aged 56.45 ± 15.76 years, and of which 65 (39.39%) CKD patients are females. The SUER was not the risk of experiencing renal endpoint events in the overall population (OR = 1.05; 95% CI: 0.680, 1.621; P = 0.826), but was an associated factor of renal endpoint events in males without diabetes (OR = 2.196; 95%CI:1.191,4.052; P = 0.012). CONCLUSIONS: An increased SUER may be an indicator for kidney function decline in male CKD patients without diabetes. Further studies should focus on subgroup analyses of CKD patients particularly in male CKD patients without diabetes to evaluate whether uric acid-lowering measures are warranted. CLINICAL TRIAL NUMBER: Not applicable.