Analysis of serum uric acid in patients with chronic kidney disease on stages 3-5 and its influencing factors

Objective To study the prevalence and risk factors of hyperuricemia (HUA) in patients with chronic kidney disease (CKD) on stages 3-5, and explore the relationship between serum uric acid and renal function. Methods 280 patients were enrolled in this study. We collected patients' clinical data, and divided the patients into two groups according to the serum uric acid levels:hyperuricemia group and normal serum uric acid group. The prevalence of HUA in patients with CKD on stages 3-5, and the differences in serum creatinine, blood urea nitrogen, blood glucose, blood pressure, blood lipid, retinol binding protein, β2 microglobulin and cystatin C were analyzed between the two groups, and the risk factors of HUA in patients with CKD on stages 3-5 were studied by the SPSS23 software. Results There were 203 patients with hyperuricemia, and 77 patients with normal serum uric acid out of the 280 patients with CKD on stages 3-5. The prevalence of HUA in patients with CKD on stages 3-5 was 72.5%, and that in CKD 3, CKD 4 and CKD 5 was 61.46%, 74.12%, and 81.82% respectively. The prevalence of HUA was increased as the decrease of glomerular filtration rate (eGFR). The prevalence of hypertension between the two groups was significantly different (P<0.05). The eGFR in hyperuricemia group was significantly decreased, and the diastolic blood pressure, retinol binding protein, β2 microglobulin and cystatin C were significantly increased as compared with normal serum uric acid group (P<0.05). Multiple regression analysis showed that the baseline serum uric acid level was negatively correlated with eGFR in patients with CKD on stages 3-5 (r=-0.277, P<0.001). The Logistic regression analysis showed that the independent risk factors of HUA in patients with CKD on stages 3-5 were hypertension, increased diastolic blood pressure and renal function deterioration (P<0.05). Conclusions The prevalence of HUA in patients with CKD on stages 3-5 is high, and increased as the decrease of eGFR. Hypertension, increased diastolic blood pressure and renal function deterioration were independent risk factors of HUA.