Keywords
Uric acid
Tubular function
How to Cite
Abstract
Introduction: Current chronic kidney disease (CKD) classification is based solely on the patient's glomerular filtration rate and albuminuria. However, it has been recently proposed that at least a tubular function marker should be incorporated into this classification. One of these proposed markers is one that evaluates urinary uric acid excretion. Additionally, it has been proposed that hyperuricemia predicts the worsening of renal function.
Objective: We decided to evaluate if there was any correlation between renal tubular uric acid handling and chronic kidney disease progression.
Materials & method: A retrospective study was performed among adult patients with stage 4-CKD who periodically attended the nephrology ambulatory consult for at least the previous 3 years. From each patient, the current fractional excretion of uric acid (FEUA) and the urine uric acid/urine creatinine ratio (UACR) were obtained, as well as a marker of GFR preservation, which was obtained as the difference (delta value) between the patient’s GFR value at the time of the study (current GFR) and their GFR three years earlier (past GFR). Finally, the correlation (Spearman test) between GFR preservation, proteinuria, FEUA, and UACR was evaluated.
Results: A total of 45 patients were included. The main findings were as follows: GFR: 21.8 ml/min/1.73 m2 ± 20.1; CKD progression: -7.9 ± 9.1; FEUA: 10.9% ± 4.5; and UACR: 4.4 mg/g ± 2.8. A positive moderate correlation (R: 0.4, p = 0.05) was documented between CKD progression and FEUA, UACR (R: 0.4, p = 0.05), and proteinuria (R: -0.4, p = 0.006).
Conclusion: FEUA and UACR showed a significant positive correlation with chronic kidney disease progression.
References
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