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

  • Fangfang Zhou
  • Geping Yu
  • Guoyu Wang
  • Yunzi Liu
  • Liwen Zhang
  • Weiming WangEmail author
  • Nan Chen
Review article



Epidemiological studies suggest that higher serum uric acid (SUA) level is significantly associated with kidney disease development. However, it remains debatable whether higher SUA is independently associated with new-onset kidney disease and rapid eGFR decline in individuals with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 and negative proteinuria.


This was a large, single-center, retrospective 6-year cohort study at People’s Hospital of Tonglu County, Zhejiang, from 2001 to 2006. We enrolled 10,677 participants (19–92 years) with eGFR ≥ 60 mL/min/1.73 m2 and without dipstick proteinuria at baseline. The association between SUA change and the occurrence of renal outcomes and annual eGFR decline were evaluated using Cox models with adjustment for confounders.


Higher quartiles (2.51%) of SUA levels were associated with greater prevalence of kidney disease compared with quartile 1 (0.52%), 2 (1.13%) and 3 (1.76%), respectively. In addition, greater baseline SUA levels [OR (95% CI) 3.29(1.68–6.45), p < 0.001] and increased SUA [1.36(1.23–1.50), p < 0.001] were all associated with greater odds of renal disease progression when comparing the 4th quartile of annual eGFR decline rate with the 1st quartile. In addition, both of higher baseline SUA levels and increased SUA change were the risk factors of rapid annual eGFR decline along with male gender, lower albumin, hematocrit and creatinine levels, higher hemoglobin levels and hyperlipidemia after multivariable adjustments when compared with each quartile group.


Increasing SUA were independent risk factor for the prevalent of kidney disease and rapid eGFR decline and reduced SUA over time could abate kidney disease development in a Chinese community.


Serum uric acid Rapid eGFR decline Renal disfunction progression 



The authors thank all participants, community health nurses and workers and other participants for their support for this study.

Author contributions

FZ and GY: conceived the study, acquired data, interpreted results, drafted manuscript and approved the final version. GW, YL and LZ: acquired data, revised manuscript and approved the final version. WW and NC: conceived the study, acquired data, interpreted results, revised manuscript and approved the final version.


This work was supported by the National Key Research and Development Program of China (grant no. 2016YFC1305402), the National Natural Science Foundation of China (no. 81270782 and 30771000), the Research Project of Science and Technology Commission of Shanghai Municipality (no. 15140902800), the Key Projects of National Basic Research Program of China 973 (no. 2012CB517701), the National Key Technology R&D Program (no. 2011BAI10B00) and Hangzhou Health Science and Technology Project (No. 2015B42).

Compliance with ethical standards

Conflict of interest

All the authors declare that they have no competing interests of this article, and there is no conflict of interest regarding the publication of this paper.

Ethics approval

This study was approved by the Ethics Committee of the Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and the patient consent were obtained.


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Copyright information

© Japanese Society of Nephrology 2019

Authors and Affiliations

  • Fangfang Zhou
    • 1
    • 2
  • Geping Yu
    • 3
  • Guoyu Wang
    • 4
  • Yunzi Liu
    • 1
    • 2
  • Liwen Zhang
    • 1
    • 2
  • Weiming Wang
    • 1
    • 2
    Email author
  • Nan Chen
    • 1
    • 2
  1. 1.Institute of NephrologyShanghai Jiao Tong University School of MedicineShanghaiChina
  2. 2.Department of Nephrology, RuiJin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
  3. 3.Department of NephrologyTonglu County First People’s HospitalHangzhouChina
  4. 4.Information SectionTonglu County First People’s HospitalHangzhouChina

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