Development of Nephrolithiasis in Asymptomatic Hyperuricemia: A Cohort Study
- Authors
- Kim, Seolhye; Chang, Yoosoo; Yun, Kyung Eun; Jung, Hyun-Suk; Lee, Soo-Jin; Shin, Hocheol; Ryu, Seungho
- Issue Date
- Aug-2017
- Publisher
- W. B. Saunders Co., Ltd.
- Keywords
- Nephrolithiasis; uric acid; hyperuricemia; cohort study; risk factor; urinary stones; kidney stone; abdominal ultrasound; sex differences; Korea
- Citation
- American Journal of Kidney Diseases, v.70, no.2, pp.173 - 181
- Indexed
- SCIE
SCOPUS
- Journal Title
- American Journal of Kidney Diseases
- Volume
- 70
- Number
- 2
- Start Page
- 173
- End Page
- 181
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/151872
- DOI
- 10.1053/j.ajkd.2017.01.053
- ISSN
- 0272-6386
- Abstract
- Background: Although the association between gout and nephrolithiasis is well known, the relationship between asymptomatic hyperuricemia and the development of nephrolithiasis is largely unknown.
Study Design: Cohort study.
Setting & Participants: 239,331 Korean adults who underwent a health checkup examination during January 2002 to December 2014 and were followed up annually or biennially through December 2014.
Predictor: Baseline serum uric acid levels of participants.
Outcome: The development of nephrolithiasis during follow-up.
Measurements: Nephrolithiasis is determined based on ultrasonographic findings. A parametric Cox model was used to estimate the adjusted HRs of nephrolithiasis according to serum uric acid level.
Results: During 1,184,653.8 person-years of follow-up, 18,777 participants developed nephrolithiasis (incidence rate, 1.6/100 person-years). Elevated uric acid level was significantly associated with increased risk for nephrolithiasis in a dose-response manner (P for trend, 0.001) in men. This dose-response association was not observed in women. In male participants, multivariable-adjusted HRs for incident nephrolithiasis comparing uric acid levels of 6.0 to 6.9, 7.0 to 7.9, 8.0 to 8.9, 9.0 to 9.9, and $10.0 mg/dL with uric acid levels, 6.0 mg/dL were 1.06 (95% CI, 1.02-1.11), 1.11 (95% CI, 1.05-1.16), 1.21 (95% CI, 1.13-1.29), 1.31 (95% CI, 1.17-1.46), and 1.72 (95% CI, 1.44-2.06), respectively. This association was observed in all clinically relevant subgroups and persisted even after adjustment for homeostasis model assessment of insulin resistance and high-sensitivity C-reactive protein level.
Limitations: Dietary information and computed tomographic diagnosis of nephrolithiasis were unavailable.
Conclusions: In this large cohort study, increased serum uric acid level was modestly and independently associated with increased risk for the development of nephrolithiasis in a dose-response manner in apparently healthy men.
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