Significance of Hyperuricemia among Community-Based Screening Participants.

BACKGROUND: Chronic kidney disease (CKD) is a risk factor of cardiovascular disease (CVD) and end-stage renal disease (ESRD). Early detection and management of risk factors of incidence and progression of CKD are necessary. We have been studying these risk factors among community-based screening participants in Okinawa, Japan. Okinawa was one of the longevity areas in the world; however, the incidence and prevalence of ESRD increased. In Japan, the incidence of ESRD is 2 times higher in men compared to that in women. Such gender difference in ESRD incidence may be explained by the difference in lifestyle-related factors such as obesity and metabolic syndrome.

SUMMARY: We have shown the significance of hyperuricemia on the incidence of ESRD and progression of CKD. Hyperuricemia was associated with increased risk of developing ESRD, in particular women. Although the causal relationship between the levels of serum uric acid (SUA) and changes in estimated glomerular filtration rate (eGFR) was not clear, we observed that high SUA was associated with larger decrease in eGFR. People with hyperuricemia, >7.0 mg/dL, may have an unhealthy lifestyle. We observed to see if intensive care, involving regular monitoring of body mass index and lifestyle and intervention when appropriate by dietitians and general practitioners, led to improved renal outcomes among patients with stage 3 CKD, compared to standard care. The benefit was observed in patients with CKD stage 3b. Key Message: Hyperuricemia is closely associated with the incidence and progression of CKD. Lifestyle modification including hyperuricemia would be the basis of management of CKD patients.