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Relationship of serum uric acid with kidney function decline mediated by systemic arterial stiffness : a retrospective cohort study in Japan

(2024) DIAGNOSTICS. 14(2).
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Abstract
Hyperuricemia is associated with kidney function decline (KFD), although whether hyperuricemia directly causes nephrotoxicity or is indirectly mediated by systemic arterial stiffening remains unclear. We examined the detailed relationship of serum uric acid (SUA) with KFD and potential mediation by arterial stiffness. Study population was 27,648 urban residents with an estimated glomerular filtration rate (eGFR) of >= 60 mL/min/1.73 m2 at baseline, and they participated in a median of three consecutive annual health examinations. Arterial stiffness was assessed using cardio-ankle vascular index (CAVI). KFD was defined as a decrease in eGFR to below 60. Multivariate analysis showed an association between baseline SUA and CAVI independent of eGFR. During the study period, 6.6% of participants developed KFD. Stratified analysis revealed a linear relationship between the contribution of CAVI or SUA and KFD. ROC analysis determined a cutoff CAVI of 8.0 (males) or 7.9 (females) and a cutoff SUA of 6.3 (males) or 4.5 mg/dL (females) for predicting KFD. The linkage between SUA and CAVI was associated with a greater increase in the hazard ratio for KFD with an increase in SUA. CAVI showed the mediating effect on the relationship of SUA with KFD after an adjustment for confounders. SUA was associated positively with CAVI-mediated KFD. Further studies should verify whether intensive SUA-lowering treatment prevents KFD via improving vascular function.
Keywords
ANKLE VASCULAR INDEX, CARDIOVASCULAR EVENTS, OXIDATIVE STRESS, FAILURE, MARKER, HYPERURICEMIA, MULTICENTER, PREDICTS, DISEASE, serum uric acid, kidney function decline, arterial stiffness, cardio-ankle vascular index

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MLA
Nagayama, Daiji, et al. “Relationship of Serum Uric Acid with Kidney Function Decline Mediated by Systemic Arterial Stiffness : A Retrospective Cohort Study in Japan.” DIAGNOSTICS, edited by Marijn Speeckaert, vol. 14, no. 2, 2024, doi:10.3390/diagnostics14020195.
APA
Nagayama, D., Watanabe, Y., Fujishiro, K., Suzuki, K., Shirai, K., Saiki, A., & Speeckaert, M. (2024). Relationship of serum uric acid with kidney function decline mediated by systemic arterial stiffness : a retrospective cohort study in Japan. DIAGNOSTICS, 14(2). https://doi.org/10.3390/diagnostics14020195
Chicago author-date
Nagayama, Daiji, Yasuhiro Watanabe, Kentaro Fujishiro, Kenji Suzuki, Kohji Shirai, Atsuhito Saiki, and Marijn Speeckaert. 2024. “Relationship of Serum Uric Acid with Kidney Function Decline Mediated by Systemic Arterial Stiffness : A Retrospective Cohort Study in Japan.” Edited by Marijn Speeckaert. DIAGNOSTICS 14 (2). https://doi.org/10.3390/diagnostics14020195.
Chicago author-date (all authors)
Nagayama, Daiji, Yasuhiro Watanabe, Kentaro Fujishiro, Kenji Suzuki, Kohji Shirai, Atsuhito Saiki, and Marijn Speeckaert. 2024. “Relationship of Serum Uric Acid with Kidney Function Decline Mediated by Systemic Arterial Stiffness : A Retrospective Cohort Study in Japan.” Ed by. Marijn Speeckaert. DIAGNOSTICS 14 (2). doi:10.3390/diagnostics14020195.
Vancouver
1.
Nagayama D, Watanabe Y, Fujishiro K, Suzuki K, Shirai K, Saiki A, et al. Relationship of serum uric acid with kidney function decline mediated by systemic arterial stiffness : a retrospective cohort study in Japan. Speeckaert M, editor. DIAGNOSTICS. 2024;14(2).
IEEE
[1]
D. Nagayama et al., “Relationship of serum uric acid with kidney function decline mediated by systemic arterial stiffness : a retrospective cohort study in Japan,” DIAGNOSTICS, vol. 14, no. 2, 2024.
@article{01J2TPVFWJ7KT65YY0P5DJP7PS,
  abstract     = {{Hyperuricemia is associated with kidney function decline (KFD), although whether hyperuricemia directly causes nephrotoxicity or is indirectly mediated by systemic arterial stiffening remains unclear. We examined the detailed relationship of serum uric acid (SUA) with KFD and potential mediation by arterial stiffness. Study population was 27,648 urban residents with an estimated glomerular filtration rate (eGFR) of >= 60 mL/min/1.73 m2 at baseline, and they participated in a median of three consecutive annual health examinations. Arterial stiffness was assessed using cardio-ankle vascular index (CAVI). KFD was defined as a decrease in eGFR to below 60. Multivariate analysis showed an association between baseline SUA and CAVI independent of eGFR. During the study period, 6.6% of participants developed KFD. Stratified analysis revealed a linear relationship between the contribution of CAVI or SUA and KFD. ROC analysis determined a cutoff CAVI of 8.0 (males) or 7.9 (females) and a cutoff SUA of 6.3 (males) or 4.5 mg/dL (females) for predicting KFD. The linkage between SUA and CAVI was associated with a greater increase in the hazard ratio for KFD with an increase in SUA. CAVI showed the mediating effect on the relationship of SUA with KFD after an adjustment for confounders. SUA was associated positively with CAVI-mediated KFD. Further studies should verify whether intensive SUA-lowering treatment prevents KFD via improving vascular function.}},
  articleno    = {{195}},
  author       = {{Nagayama, Daiji and  Watanabe, Yasuhiro and  Fujishiro, Kentaro and  Suzuki, Kenji and  Shirai, Kohji and  Saiki, Atsuhito and Speeckaert, Marijn}},
  editor       = {{Speeckaert, Marijn}},
  issn         = {{2075-4418}},
  journal      = {{DIAGNOSTICS}},
  keywords     = {{ANKLE VASCULAR INDEX,CARDIOVASCULAR EVENTS,OXIDATIVE STRESS,FAILURE,MARKER,HYPERURICEMIA,MULTICENTER,PREDICTS,DISEASE,serum uric acid,kidney function decline,arterial stiffness,cardio-ankle vascular index}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{11}},
  title        = {{Relationship of serum uric acid with kidney function decline mediated by systemic arterial stiffness : a retrospective cohort study in Japan}},
  url          = {{http://doi.org/10.3390/diagnostics14020195}},
  volume       = {{14}},
  year         = {{2024}},
}

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