Hyperuricemia as a predictive marker for progression of nephrosclerosis: Clinical assessment of prognostic factors in biopsy-proven arterial/arteriolar nephrosclerosis

Aim: the influence of serum urate on kidney disease is attracting attention,but the effects of uric acid (ua) on nephrosclerosis have not been elucidated. methods: we reviewed data from 45 patients diagnosed with arterial/arteriolar nephrosclerosis. the renal outcomes of the arterial/arteriolar nephrosclerosis patients were assessed by performing logistic and cox regression analyses. a kaplan–meier analysis was used to evaluate the impact of hyperuricemia (hu) on kidney survival. the renal outcomes of patients with and without hu were compared by using a propensity score-matched cohort. results: the logistic regression models showed no significant differences in renal outcomes,according to baseline parameters or follow-up parameters,except the serum ua value and body mass index (bmi). baseline serum ua level had the highest odds ratio (or) for estimated glomerular filtration rate (egfr) decline (or,1.86; 95% confidence interval (ci),1.12 to 3.45),among the parameters assessed. in the multivariate cox regression analysis,hu (ua ≥8.0 mg/dl) (p=0.01) and bmi (p= 0.03) were significantly associated with a ≥50% egfr decline or esrd. the kaplan–meier analysis in the propensity score-matched cohort indicated that the renal survival rate of the group of arterial/arteriolar nephrosclerosis patients with hu was significantly lower than that of the group without hu (log rank,p=0.03). conclusion: the results of this study suggest that the baseline serum ua value can serve as a renal outcome predictor in arterial/arteriolar nephrosclerosis patients. © 2017 japan atherosclerosis society.