Meta-analysis of observational cohort studies on the relationships of asymptomatic hyperuricemia with chronic kidney disease

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Studying the relationship between the level of uric acid (UA) and glomerular filtration rate (GFR) is a pressing interdisciplinary problem in the clinic of internal medicine.

Objective: to evaluate the effect of serum UA levels on GFR in patients with initially normal and reduced renal function using a systematic review of cohort observational studies and evaluation of its results based on meta-analysis.

Material and methods. A systematic search and selection of publications was carried out in the Embase, PubMed, Cochrane Library, and eLibrary databases. During the first stage of the study, the relationship between the level of UA in the blood serum and GFR was determined based on the initial data of patients when included in observation. At the second stage, the dynamics of GFR was analyzed in a population of patients mixed by the presence of chronic kidney disease (CKD) over observation periods of up to 6 years and from 6 to 10 years. The meta-analysis assessed the clinical and methodological heterogeneity of the included studies, as well as publication bias and risk of bias.

Results. The meta-analysis included 23 eligible clinical trials (involving 216,479 patients). As a result of the analysis, it was revealed that an increase in the level of UA in the blood serum by 1 mg/dL leads to a decrease in GFR by 1,18 (95% CI from -1,24 to -1,12) ml/min/1,73 m2 in individuals with initially normal renal function and by 1,87 (95% CI from -1,90 to -1,83) ml/min/1,73 m2 in a cohort of patients mixed by the presence of CKD. Moreover, data were obtained that demonstrated a statistically significant decrease in GFR by 4,44 (95% CI from -7,65 to -1,23) ml/min/1,73 m2 during 6 years of follow-up and by 6,21 (95% CI from -8,09 to -4,34) ml/min/1,73 m2 over a follow-up period of more than 6 years in a mixed CKD population of patients suffering from asymptomatic hyperuricemia (AHU).

Conclusion. The results of this meta-analysis showed a statistically significant negative effect of increasing serum UA levels on GFR both in individuals with initially normal renal function and in a cohort of patients mixed in terms of the presence of CKD. Along with this, it was found that a decrease in the filtration function of the kidneys against the background of hyperuricemia in a population of patients mixed in terms of the presence of CKD tends to progress with a longer period of observation. Thus, therapeutic measures aimed at reducing the level of sUA in the blood serum in individuals with AHU can serve as an additional factor of nephroprotection to prevent the development and progression of kidney pathology.

Full Text

Restricted Access

About the authors

Vadim I. Mazurov

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25

Author for correspondence.
Email: maz.nwgmu@yandex.ru
ORCID iD: 0000-0002-0797-2051
SPIN-code: 6823-5482
Scopus Author ID: 16936315400

MD, professor, academician of RAS, principal scientific advisor, director of the Research institute of rheumatology and head of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald of I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; head of autoimmune center of Clinical Rheumatology Hospital No. 25 (Saint Petersburg); Honored Worker of Science of the Russian Federation

Russian Federation, Saint Petersburg; Saint Petersburg

Oksana M. Drapkina

National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia

Email: drapkina@bk.ru
ORCID iD: 0000-0002-4453-8430
SPIN-code: 4456-1297
Scopus Author ID: 57208852308

MD, professor, academician of RAS, director and head of the Department of basic and applied aspects of obesity, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia; chief external specialist in therapy and general medical practice of the Ministry of Healthcare of Russia; president of Russian Society for the Prevention of Non-Infectious Diseases

Russian Federation, Moscow

Anatoly I. Martynov

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

Email: idjema@gmail.com
ORCID iD: 0000-0002-0783-488X
SPIN-code: 5271-3173
Scopus Author ID: 7102769644

MD, professor, academician of RAS, professor of the Department of hospital therapy No. 1, A.I. Yevdokimov Moscow State University of Medicine and Dentistry Ministry of Healthcare of Russia; president of Russian Scientific Medical Society of Internal Medicine

Russian Federation, Moscow

Sergey A. Sayganov

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia

Email: sergey.saiganov@szgmu.ru
ORCID iD: 0000-0001-8325-1937
SPIN-code: 2174-6400
Scopus Author ID: 36140532200

MD, professor, rector and head of the Department of hospital therapy and cardiology named after M.S. Kushakovsky, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia

Russian Federation, Saint Petersburg

Roman A. Bashkinov

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25

Email: bashkinov-roman@mail.ru
ORCID iD: 0000-0001-9344-1304
SPIN-code: 5169-5066
Scopus Author ID: 57221994610

postgraduate student of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; rheumatologist at Clinical Rheumatology Hospital No. 25 (Saint Petersburg)

Russian Federation, Saint Petersburg; Saint Petersburg

Inna Z. Gaydukova

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25

Email: ubp1976@list.ru
ORCID iD: 0000-0003-3500-7256
SPIN-code: 3083-7996
Scopus Author ID: 55237525900

MD, professor, deputy director of the Research institute of rheumatology and professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; rheumatologist at Clinical Rheumatology Hospital No. 25» (Saint-Petersburg)

Russian Federation, Saint Petersburg; Saint Petersburg

Kirill V. Sapozhnikov

Russian Presidential Academy of National Economy and Public Administration

Email: marinheira@rambler.ru
ORCID iD: 0000-0002-2476-7666
SPIN-code: 2707-0339
Scopus Author ID: 57200810332

PhD in Medical Sciences, independent expert on research projects of Project Office of the North-West Institute of Management – a branch office of Russian Presidential Academy of National Economy and Public Administration»

Russian Federation, Moscow

Daria G. Tolkacheva

Russian Presidential Academy of National Economy and Public Administration

Email: tolkacheva.d@gmail.com
ORCID iD: 0000-0002-6314-4218
Scopus Author ID: 57221817074

independent expert on research projects of Project Office of the North-West Institute of Management – a branch office of Russian Presidential Academy of National Economy and Public Administration»

Russian Federation, Moscow

Natalia A. Sableva

Russian Presidential Academy of National Economy and Public Administration

Email: sablevana@gmail.com
ORCID iD: 0000-0002-5809-9221
Scopus Author ID: 57712944300

independent expert on research projects of Project Office of the North-West Institute of Management – a branch office of Russian Presidential Academy of National Economy and Public Administration

Russian Federation, Moscow

Alexandra Y. Tsinserling

I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatology Hospital No. 25

Email: aleksa.fonturenko@mail.ru
ORCID iD: 0000-0003-4860-0518
SPIN-code: 5613-9035

senior laboratory assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia rheumatologist at Clinical Rheumatology Hospital No. 25» (Saint-Petersburg)

Russian Federation, Saint Petersburg; Saint Petersburg

References

  1. Драпкина О.М., Мазуров В.И., Мартынов А.И. с соавт. «В фокусе гиперурикемия». Резолюция Cовета экспертов. Кардиоваскулярная терапия и профилактика. 2023; 22(4): 77–84. [Drapkina O.M., Mazurov V.I., Martynov A.I. et al. «Focus on hyperuricemia». The resolution of the Expert Council. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2023; 22(4): 77–84 (In Russ.)]. https://dx.doi.org/10.15829/1728-8800-2023-3564. EDN: KRCKAU.
  2. Neilson J., Bonnon A., Dickson A., Roddy E.; Guideline Committee. Gout: diagnosis and management-summary of NICE guidance. BMJ. 2022; 378: o1754. https://dx.doi.org/10.1136/bmj.o1754.
  3. Bursill D., Taylor W.J., Terkeltaub R. et al. Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout. Ann Rheum Dis. 2019; 78(11): 1592–600. https://dx.doi.org/10.1136/annrheumdis-2019-215933.
  4. Dalbeth N., Gosling A.L., Gaffo A., Abhishek A. Gout [published correction appears in Lancet. 2021 May 15; 397(10287): 1808]. Lancet. 2021; 397(10287): 1843–55. https://dx.doi.org/10.1016/S0140-6736(21)00569-9.
  5. Chen-Xu M., Yokose C., Rai S.K. et al. Contemporary prevalence of gout and hyperuricemia in the United States and decadal trends: The National Health and Nutrition Examination Survey, 2007–2016. Arthritis Rheumatol. 2019; 71(6): 991–99. https://dx.doi.org/10.1002/art.40807.
  6. Шальнова С.А., Деев А.Д., Артамонова Г.В. с соавт. Гиперурикемия и ее корреляты в российской популяции (результаты эпидемиологического исследования ЭССЕ-РФ). Рациональная фармакотерапия в кардиологии. 2014; 10(2): 153–159. [Shalnova S.A., Deev A.D., Artamonova G.V. et al. Hyperuricemia and its correlates in the Russian population (results of ESSE-RF epidemiological study). Ratsional’naya farmakoterapiya v kardiologii = Rational Pharmacotherapy in Cardiology. 2014; 10(2): 153–159 (In Russ.)]. https://dx.doi.org/10.20996/1819-6446-2014-10-2-153-159. EDN: SCOUHN.
  7. Lipkowitz M.S. Regulation of uric acid excretion by the kidney. Curr Rheumatol Rep. 2012; 14(2): 179–88. https://dx.doi.org/10.1007/s11926-012-0240-z.
  8. Maiuolo J., Oppedisano F., Gratteri S. et al. Regulation of uric acid metabolism and excretion [published correction appears in Int J Cardiol. 2023; 387: 131126]. Int J Cardiol. 2016; 213: 8–14. https://dx.doi.org/10.1016/j.ijcard.2015.08.109.
  9. Reginato A.M., Mount D.B., Yang I., Choi H.K. The genetics of hyperuricaemia and gout. Nat Rev Rheumatol. 2012; 8(10): 610–21. https://dx.doi.org/10.1038/nrrheum.2012.144.
  10. Мазуров В.И., Башкинов Р.А., Гайдукова И.З., Фонтуренко А.Ю. Влияние бессимптомной гиперурикемии на коморбидные заболевания и возможности ее коррекции. РМЖ. 2021; 29(7): 24–30. [Mazurov V.I., Bashkinov R.A., Gaidukova I.Z., Fonturenko A.Yu. The effect of asymptomatic hyperuricemia on comorbidities and the possibility of its correction. Russkiy meditsinskiy zhurnal = Russian Medical Journal. 2021; 29(7): 24–30 (In Russ.)]. EDN: EZWQOO.
  11. Yip K., Cohen R.E., Pillinger M.H. Asymptomatic hyperuricemia: is it really asymptomatic? Curr Opin Rheumatol. 2020; 32(1): 71–79. https://dx.doi.org/10.1097/BOR.0000000000000679.
  12. Zhang S., Wang Y., Cheng J. et al. Hyperuricemia and cardiovascular disease. Curr Pharm Des. 2019; 25(6): 700–9. https://dx.doi.org/10.2174/1381612825666190408122557.
  13. Borghi C., Agabiti-Rosei E., Johnson R.J. et al. Hyperuricaemia and gout in cardiovascular, metabolic and kidney disease. Eur J Intern Med. 2020; 80: 1–11. https://dx.doi.org/10.1016/j.ejim.2020.07.006.
  14. Wang H., Zhang H., Sun L., Guo W. Roles of hyperuricemia in metabolic syndrome and cardiac-kidney-vascular system diseases. Am J Transl Res. 2018; 10(9): 2749–63.
  15. Borghi C., Tykarski A., Widecka K. et al. Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk. Cardiol J. 2018; 25(5): 545–63. https://dx.doi.org/10.5603/CJ.2018.0116.
  16. Borghi C., Domienik-Karłowicz J., Tykarski A. et al. Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk: 2021 update. Cardiol J. 2021; 28(1): 1–14. https://dx.doi.org/10.5603/CJ.a2021.0001.
  17. Чазова И.Е., Жернакова Ю.В., Кисляк О.А. с соавт. Консенсус по ведению пациентов с гиперурикемией и высоким сердечно-сосудистым риском: 2022. Системные гипертензии. 2022; 19(1): 5–22. [Chazova I.E., Zhernakova Yu.V., Kislyak O.A. et al. Consensus on patients with hyperuricemia and high cardiovascular risk treatment: 2022. Sistemnye gipertenzii = Systemic Hypertension. 2022; 19(1): 5–22 (In Russ.)]. https://dx.doi.org/10.38109/2075-082X-2022-1-5-22. EDN: HBLVVV.
  18. Sanchez-Lozada L.G. The pathophysiology of uric acid on renal diseases. Contrib Nephrol. 2018; 192: 17–24. https://dx.doi.org/10.1159/000484274.
  19. Koo B.S., Jeong H.J., Son C.N. et al. J-shaped relationship between chronic kidney disease and serum uric acid levels: A cross-sectional study on the Korean population. J Rheum Dis. 2021; 28(4): 225–33. https://dx.doi.org/10.4078/jrd.2021.28.4.225.
  20. Tsai C.W., Lin S.Y., Kuo C.C., Huang C.C. Serum uric acid and progression of kidney disease: A longitudinal analysis and mini-review. PLoS One. 2017; 12(1): e0170393. https://dx.doi.org/10.1371/journal.pone.0170393.
  21. Li L., Yang C., Zhao Y. et al. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease? A systematic review and meta-analysis based on observational cohort studies. BMC Nephrol. 2014; 15: 122. https://dx.doi.org/10.1186/1471-2369-15-122.
  22. Zhu P., Liu Y., Han L. et al. Serum uric acid is associated with incident chronic kidney disease in middle-aged populations: A meta-analysis of 15 cohort studies. PLoS One. 2014; 9(6): e100801. https://dx.doi.org/10.1371/journal.pone.0100801.
  23. Li Y.L., Wang L., Li J. et al. The correlation between uric acid and the incidence and prognosis of kidney diseases: A systematic review and meta-analysis of cohort studies. Zhonghua Nei Ke Za Zhi. 2011; 50(7): 555–61.
  24. Sharma G., Dubey A., Nolkha N., Singh J.A. Hyperuricemia, urate-lowering therapy, and kidney outcomes: A systematic review and meta-analysis. Ther Adv Musculoskelet Dis. 2021; 13: 1759720X211016661. https://dx.doi.org/10.1177/1759720X211016661.
  25. Nashar K., Fried L.F. Hyperuricemia and the progression of chronic kidney disease: Is uric acid a marker or an independent risk factor? Adv Chronic Kidney Dis. 2012; 19(6): 386–91. https://dx.doi.org/10.1053/j.ackd.2012.05.004.
  26. Paul B.J., Anoopkumar K., Krishnan V. Asymptomatic hyperuricemia: Is it time to intervene? Clin Rheumatol. 2017; 36(12): 2637–44. https://dx.doi.org/10.1007/s10067-017-3851-y.
  27. Higgins J.P.T, Thomas J., Chandler J. et al (editors). Cochrane handbook for systematic reviews of interventions version 6.3. Cochrane, 2022. URL: www.training.cochrane.org/handbook (date of access – 07.07.2023).
  28. Zhou F., Yu G., Wang G. et al. Association of serum uric acid levels with the incident of kidney disease and rapid eGFR decline in Chinese individuals with eGFR >60 mL/min/1.73 m2 and negative proteinuria. Clin Exp Nephrol. 2019; 23(7): 871–79. https://dx.doi.org/10.1007/s10157-019-01705-w.
  29. Kuwata H., Okamura S., Hayashino Y. et al. Serum uric acid levels are associated with a high risk of rapid chronic kidney disease progression among patients with type 2 diabetes: A prospective cohort study [Diabetes Distress and Care Registry at Tenri (DDCRT 12)]. Diabetol Int. 2016; 7(4): 352–60. https://dx.doi.org/10.1007/s13340-016-0254-2.
  30. Liu L., Gao B., Wang J. et al. Time-averaged serum uric acid and 10-year incident diabetic kidney disease: A prospective study from China. J Diabetes. 2020; 12(2): 169–78. https://dx.doi.org/10.1111/1753-0407.12983.
  31. Takae K., Nagata M., Hata J. et al. Serum uric acid as a risk factor for chronic kidney disease in a Japanese Community – The Hisayama study. Circ J. 2016; 80(8): 1857–62. https://dx.doi.org/10.1253/circj.CJ-16-0030.
  32. Ryoo J.H., Choi J.M., Oh C.M., Kim M.G. The association between uric acid and chronic kidney disease in Korean men: A 4-year follow-up study. J Korean Med Sci. 2013; 28(6): 855–60. https://dx.doi.org/10.3346/jkms.2013.28.6.855.
  33. Kim W.J., Kim S.S., Bae M.J. et al. High-normal serum uric acid predicts the development of chronic kidney disease in patients with type 2 diabetes mellitus and preserved kidney function. J Diabetes Complications. 2014; 28(2): 130–34. https://dx.doi.org/10.1016/j.jdiacomp.2013.11.006.
  34. Nagano S., Takahashi M., Miyai N. et al. Association of serum uric acid with subsequent arterial stiffness and renal function in normotensive subjects. Hypertens Res. 2017; 40(6): 620–24. https://dx.doi.org/10.1038/hr.2017.10.
  35. De Cosmo S., Viazzi F., Pacilli A. et al. Serum uric acid and risk of CKD in type 2 diabetes. Clin J Am Soc Nephrol. 2015; 10(11): 1921–29. https://dx.doi.org/10.2215/CJN.03140315.
  36. Cao X., Wu L., Chen Z. The association between elevated serum uric acid level and an increased risk of renal function decline in a health checkup cohort in China. Int Urol Nephrol. 2018; 50(3): 517–25. https://dx.doi.org/10.1007/s11255-017-1732-6.
  37. Zoppini G., Targher G., Chonchol M. et al. Serum uric acid levels and incident chronic kidney disease in patients with type 2 diabetes and preserved kidney function. Diabetes Care. 2012; 35(1): 99–104. https://dx.doi.org/10.2337/dc11-1346.
  38. Chini L.S.N., Assis L.I.S., Lugon J.R. Relationship between uric acid levels and risk of chronic kidney disease in a retrospective cohort of Brazilian workers. Braz J Med Biol Res. 2017; 50(9): e6048. https://dx.doi.org/10.1590/1414-431X20176048.
  39. Aiumtrakul N., Wiputhanuphongs P., Supasyndh O., Satirapoj B. Hyperuricemia and impaired renal function: A prospective cohort study. Kidney Dis (Basel). 2021; 7(3): 210–18. https://dx.doi.org/10.1159/000511196.
  40. Wang S., Shu Z., Tao Q. et al. Uric acid and incident chronic kidney disease in a large health check-up population in Taiwan. Nephrology (Carlton). 2011; 16(8): 767–76. https://dx.doi.org/10.1111/j.1440-1797.2011.01513.
  41. Chen Z., Ding Z., Fu C. et al. Correlation between serum uric Acid and renal function in patients with stable coronary artery disease and type 2 diabetes. J Clin Med Res. 2014; 6(6): 443–50. https://dx.doi.org/10.14740/jocmr1909w.
  42. Chonchol M., Shlipak M.G., Katz R. et al. Relationship of uric acid with progression of kidney disease. Am J Kidney Dis. 2007; 50(2): 239–47. https://dx.doi.org/10.1053/j.ajkd.2007.05.013.
  43. Hung Y.H., Huang C.C., Lin L.Y., Chen J.W. Uric acid and impairment of renal function in non-diabetic hypertensive patients. Front Med (Lausanne). 2022; 8: 746886. https://dx.doi.org/10.3389/fmed.2021.746886.
  44. Kikuchi A., Kawamoto R., Ninomiya D., Kumagi T. Hyperuricemia is associated with all-cause mortality among males and females: Findings from a study on Japanese community-dwelling individuals. Metabol Open. 2022; 14: 100186. https://dx.doi.org/10.1016/j.metop.2022.100186.
  45. Kuwabara M., Niwa K., Hisatome I. et al. Asymptomatic hyperuricemia without comorbidities predicts cardiometabolic diseases: Five-year Japanese cohort study. Hypertension. 2017; 69(6): 1036–44. https://dx.doi.org/10.1161/HYPERTENSIONAHA.116.08998.
  46. Sedaghat S., Hoorn E.J., van Rooij F.J. et al. Serum uric acid and chronic kidney disease: the role of hypertension. PLoS One. 2013; 8(11): e76827. https://dx.doi.org/10.1371/journal.pone.0076827.
  47. Srivastava A., Kaze A.D., McMullan C.J. et al. Uric acid and the risks of kidney failure and death in individuals with CKD. Am J Kidney Dis. 2018; 71(3): 362–70. https://dx.doi.org/10.1053/j.ajkd.2017.08.017.
  48. Weiner D.E., Tighiouart H., Elsayed E.F. et al. Uric acid and incident kidney disease in the community. J Am Soc Nephrol. 2008; 19(6): 1204–11. https://dx.doi.org/10.1681/ASN.2007101075.
  49. Yamada T., Fukatsu M., Suzuki S. et al. Elevated serum uric acid predicts chronic kidney disease. Am J Med Sci. 2011; 342(6): 461–66. https://dx.doi.org/10.1097/MAJ.0b013e318218bd89.
  50. Мазуров В.И., Сайганов С.А., Башкинов Р.А. с соавт. Влияние уратснижающей терапии на течение хронической болезни почек у пациентов с остеоартритом и бессимптомной гиперурикемией. Терапия. 2023; 9(7): 56–71. [Mazurov V.I., Sayganov S.A., Bashkinov R.A. et al. Effect of urate-lowering therapy on the progression of chronic kidney disease in patients with osteoarthritis and asymptomatic hyperuricemia. Terapiya = Therapy. 2023; 9(7): 56–71 (In Russ.)]. https://dx.doi.org/10.18565/therapy.2023.7.56-71. EDN: RDYJFA.
  51. Piani F., Johnson R.J. Does gouty nephropathy exist, and is it more common than we think? Kidney Int. 2021; 99(1): 31–33. https://dx.doi.org/10.1016/j.kint.2020.10.015.
  52. Bardin T., Nguyen Q.D., Tran K.M. et al. A cross-sectional study of 502 patients found a diffuse hyperechoic kidney medulla pattern in patients with severe gout. Kidney Int. 2021; 99(1): 218–26. https://dx.doi.org/10.1016/j.kint.2020.08.024.
  53. Kim Y.J., Oh S.H., Ahn J.S. et al. The crucial role of xanthine oxidase in CKD progression associated with hypercholesterolemia. Int J Mol Sci. 2020; 21(20): 7444. https://dx.doi.org/10.3390/ijms21207444.
  54. Sanchez-Lozada L.G., Soto V., Tapia E. et al. Role of oxidative stress in the renal abnormalities induced by experimental hyperuricemia. Am J Physiol Renal Physiol. 2008; 295(4): F1134–41. https://dx.doi.org/10.1152/ajprenal.00104.2008.
  55. Kang D.H., Nakagawa T., Feng L. et al. A role for uric acid in the progression of renal disease. J Am Soc Nephrol. 2002; 13(12): 2888–97. https://dx.doi.org/10.1097/01.asn.0000034910.58454.fd.
  56. Sanchez-Lozada L.G., Tapia E., Santamaria J. et al. Mild hyperuricemia induces vasoconstriction and maintains glomerular hypertension in normal and remnant kidney rats. Kidney Int. 2005; 67(1): 237–47. https://dx.doi.org/10.1111/j.1523-1755.2005.00074.x.
  57. Dissanayake L.V., Spires D.R., Palygin O., Staruschenko A. Effects of uric acid dysregulation on the kidney. Am J Physiol Renal Physiol. 2020; 318(5): F1252–57. https://dx.doi.org/10.1152/ajprenal.00066.2020.
  58. Wu N., Xia J., Chen S. et al. Serum uric acid and risk of incident chronic kidney disease: A national cohort study and updated meta-analysis. Nutr Metab (Lond). 2021; 18(1): 94. https://dx.doi.org/10.1186/s12986-021-00618-4.
  59. Gonçalves D.L.N., Moreira T.R., da Silva L.S. A systematic review and meta-analysis of the association between uric acid levels and chronic kidney disease. Sci Rep. 2022; 12(1): 6251. https://dx.doi.org/10.1038/s41598-022-10118-x.
  60. Xia X., Luo Q., Li B. et al. Serum uric acid and mortality in chronic kidney disease: A systematic review and meta-analysis. Metabolism. 2016; 65(9): 1326–41. https://dx.doi.org/10.1016/j.metabol.2016.05.009.
  61. Zhang J., Lu X., Li H., Wang S. Serum uric acid and mortality in patients with chronic kidney disease: A systematic review and meta-analysis. Blood Purif. 2021; 50(6): 758–66. https://dx.doi.org/10.1159/000513944.
  62. Luo Q., Xia X., Li B. et al. Serum uric acid and cardiovascular mortality in chronic kidney disease: A meta-analysis. BMC Nephrol. 2019; 20(1): 18. https://dx.doi.org/10.1186/s12882-018-1143-7.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Appendix
Download (197KB)
Indexing metadata
3. Fig. 1. Results of a systematic search and selection of publications to perform a meta-analysis (PRISMA flow chart)

Download (253KB)
Indexing metadata
4. Fig. 2. The result of the synthesis of descriptive statistics on the level of uric acid in blood serum from observational studies

Download (231KB)
Indexing metadata
5. Fig. 3. Generalization of data to determine the relationship between serum uric acid (UA) levels and glomerular filtration rate (GFR) in a population of patients with initially normal renal function

Download (703KB)
Indexing metadata
6. Fig. 4. Generalization of data to determine the relationship between the level of uric acid (UA) in the blood serum and the glomerular filtration rate (GFR) in a population of patients mixed by the presence of chronic kidney disease

Download (913KB)
Indexing metadata
7. Fig. 5. Synthesis of assessment of the results of changes in glomerular filtration rate (GFR) in studies with a follow-up period of less than 6 years

Download (201KB)
Indexing metadata
8. Fig. 6. Synthesis of assessment of the results of changes in glomerular filtration rate (GFR) in studies with a follow-up period of more than 6 years

Download (213KB)
Indexing metadata

Copyright (c) 2024 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies