Uric acid is not associated with decline in renal function or time to renal replacement therapy initiation in a referred cohort of XXXX with Stage III, IV and V chronic kidney disease.

@entity1 @entity8 @entity1009 @entity740 @entity177 @entity204 @entity414
BACKGROUND: Although many studies have suggested an association between higher @entity414 (UA) and both development of @entity740 ( @entity740 ) and @entity177 in Stage I and II @entity740 , it is not clear whether this effect is consistent throughout higher @entity740 stages. The aim of this study was to investigate the association between baseline UA and renal outcomes in @entity1 with established @entity740 (Stages III-V). METHODS: We analysed data in the Swedish @entity8 (SRR- @entity740 ), which is a nationwide registry of referred @entity740 @entity1 . @entity1 with a visit between January 1(st), 2005 and December 31(st), 2011 were followed until initiation of renal replacement therapy (RRT), @entity204 , referral to primary care or end of follow-up. Decline in renal function was assessed with a linear mixed model using all estimated glomerular filtration rate (eGFR) assessments recorded during median 28 months of follow-up, adjusting for important confounders such as demographic factors, primary @entity8 , age, sex, relevant medication, diet, blood pressure and body mass index. RESULTS: There were 2466 @entity1 with a baseline UA measurement {mean [standard deviation (SD)] of 7.81 [1.98] mg/dL}. The mean decline in renal function was -1.48 (95% CI -1.65; -1.31) mL/ @entity1009 .73 m(2) per year. The overall adjusted change in decline in renal function per unit increase in baseline UA was 0.08 (95% CI -0.01; 0.17) mL/ @entity1009 .73 m(2) per year indicating no association between higher UA levels and decline in renal function. In Stage III, IV and V @entity740 @entity1 , the mean decline in renal function was -1.52 (95% CI -1.96; -1.08), -1.52 (95% CI -1.72; -1.32) and -1.19 (95% CI -1.75; -0.64) mL/ @entity1009 .73 m(2) per year, respectively. The adjusted change in the decline in renal function per unit increase in baseline UA was -0.09 (95% CI -0.30; 0.13) in Stage III @entity740 , 0.16 (95% CI 0.04; 0.28) in Stage IV @entity740 and 0.18 (95% CI -0.09; 0.45) in Stage V @entity740 . The overall adjusted hazard ratio for start of RRT was 0.97 (95% CI 0.93-1.02). For Stage III, IV and V @entity740 , it was 0.99 (95% CI 0.73-1.34), 0.97 (95% CI 0.91-1.03) and 0.99 (95% CI 0.91-1.07), respectively. CONCLUSION: UA is not associated with the rate of decline in renal function or time to start of RRT in Stage III, IV and/or V @entity740 @entity1 .
