Prevalence and prognosis of asymptomatic hyperuricemia in chronic kidney disease in Xinjiang: a multicenter study

Objective To explore the prevalence and prognosis of asymptomatic hyperuricemia(AH) in patients with chronic kidney disease(CKD) in Xinjiang Uygur Autonomous Region and provide rationales for optimizing management strategies.Methods From January 2019 to December 2019,1346 patients of CKD stages 1-5 without receiving dialysis hospitalized at People’s Hospital of Xinjiang Uygur Autonomous Region,Hospital of Shache County,Beijing Road Medical Area,General Hospital of Xinjiang Military Command,People’s Hospital of Xinjiang Hetian District,Xinjiang Friendship Hospital,Xinjiang Production & Construction Corps Hospital in Xinjiang Uygur Autonomous Region were enrolled through cluster sampling.Medical history and laboratory test results were recorded.The prevalence,risk factors and prognosis of AH patients at different CKD stages were examined.767 CKD patients without receiving dialysis having complete medical record data and fulfilling the inclusion/exclusion criteria were enrolled.The average age was(51±15)(18-87) years.There were 334 AH patients with a prevalence of 43.5% and serum level of uric acid was(489.22±85.71) μmol/L.The prevalence of AH was higher in male CKD patients than that in female CKD counterparts(60.5% vs 39.5%).The prevalence of patients of Han ethnicity were higher than that of minority ethnicities(55.4% vs 44.6%,P＜0.05).As compared with those with normal serum level of uric acid,AH patients had significantly higher comorbidities of hypertension,obesity,body mass index(BMI),blood urea nitrogen,creatinine,C-reactive protein,cholesterol,phosphorus,magnesium and parathyroid hormone.Estimated glomerular filtration rate(eGFR) and serum hemoglobin in AH patients were significantly lower than CKD patients without AH.Multivariate Logistic regression analysis revealed that low serum levels of hemoglobin and albumin were independent risk factors for endpoint events of ≥30% decline of eGFR or requirement of kidney replacement therapy in CKD patients.AH was not an independent risk factor for endpoint event.And 225 follow-up CKD patients with AH were further examined.The incidence of endpoint events in patients with non-normalized serum level of uric acid after treatment was significantly higher than that in those with normalized level of uric after treatment and those without treatment(P＜0.05).Conclusion The prevalence of AH in CKD patients in Xinjiang Uygur Autonomous Region is higher than that in general population.Correcting hyperuricemia in CKD patients with AH helps to arrest the deterioration of kidney function and improve patient prognosis.