ArticlePloS one2015
Targeting Uric Acid and the Inhibition of Progression to End-Stage Renal Disease--A Propensity Score Analysis.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
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Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Uric acid in CKD: has the jury come to the verdict?Journal of nephrology · 2020Pooled it
- Xanthine oxidase inhibitors are associated with reduced risk of cardiovascular disease.Scientific reports · 2021Trial
- Estimating covariate-balanced survival curve in distributed data environment using data collaboration quasi-experiment.Scientific reports · 2026Article
- Feature-based clustering of hemoglobin trajectories and subsequent risk of end-stage kidney disease in stages 3-4 CKD: a landmark analysis.Frontiers in nutrition · 2026Article
- High Levels of Galectin-3 and Uric Acid Are Independent Predictors of Renal Impairment in Patients with Stable Coronary Artery Disease.Journal of clinical medicine · 2025Article
- Asymptomatic Hyperuricemia and the Kidney: Lessons from the URRAH Study.Metabolites · 2025Review
- Approximation of Glomerular Filtration Rate after 1 Year Using Annual Medical Examination Data.Journal of clinical medicine · 2024Article
- Clinicopathological characteristics and associated factors of idiopathic membranous nephropathy with hyperuricemia: a single-centered cross-sectional study.International urology and nephrology · 2023Article
- Effects of Uric Acid-Lowering Therapy on the Kidney (HTR-2023-0096.R2).Hypertension research : official journal of the Japanese Society of Hypertension · 2023Article
- Article
- Longitudinal uric acid has nonlinear association with kidney failure and mortality in chronic kidney disease.Scientific reports · 2023Article
- The Efficacy and Safety of Dotinurad on Uric Acid and Renal Function in Patients with Hyperuricemia and Advanced Chronic Kidney Disease: A Single Center, Retrospective Analysis.Drug design, development and therapy · 2023Article
- Lower bicarbonate level is associated with CKD progression and all-cause mortality: a propensity score matching analysis.BMC nephrology · 2022Article
- Article
- Hyperuricemia and Associated Factors in Children with Chronic Kidney Disease: A Cross-Sectional Study.Children (Basel, Switzerland) · 2021Article
- Anemia and atrial fibrillation as independent risk factors for new-onset chronic kidney disease: the TAMA-MED Project-CKD and AF.Clinical kidney journal · 2021Article
- Renal disorders in rheumatologic diseases: the spectrum is changing (part 2. Arthridides).Journal of nephrology · 2021Review
- Effectiveness of Drug Treatments for Lowering Uric Acid on Renal Function in Patients With Chronic Kidney Disease and Hyperuricemia: A Network Meta-Analysis of Randomized Controlled Trials.Frontiers in pharmacology · 2021Article
- A longitudinal analysis of the relationship between serum uric acid and residual renal function loss in peritoneal dialysis patients.Renal failure · 2020Observational
- Renal effects of uric acid: hyperuricemia and hypouricemia.The Korean journal of internal medicine · 2020Review
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe role of uric acid (UA) in the progression of chronic kidney disease (CKD) remains controversial due to the unavoidable cause and result relationship. This study was aimed to clarify the independent impact of UA on the subsequent risk of end-stage renal disease (ESRD) by a propensity score analysis.
methodsA retrospective CKD cohort was used (n = 803). Baseline 23 covariates were subjected to a multivariate binary logistic regression with the targeted time-averaged UA of 6.0, 6.5 or 7.0 mg/dL. The participants trimmed 2.5 percentile from the extreme ends of the cohort underwent propensity score analyses consisting of matching, stratification on quintile and covariate adjustment. Covariate balances after 1:1 matching without replacement were tested for by paired analysis and standardized differences. A stratified Cox regression and a Cox regression adjusted for logit of propensity scores were examined.
resultsAfter propensity score matching, the higher UA showed elevated hazard ratios (HRs) by Kaplan-Meier analysis (≥ 6.0 mg/dL, HR 4.53, 95%CI 1.79-11.43; ≥ 6.5 mg/dL, HR 3.39, 95%CI 1.55-7.42; ≥ 7.0 mg/dL, HR 2.19, 95%CI 1.28-3.75). The number needed to treat was 8 to 9 over 5 years. A stratified Cox regression likewise showed significant crude HRs (≥ 6.0 mg/dL, HR 3.63, 95%CI 1.25-10.58; ≥ 6.5 mg/dL, HR 3.46, 95%CI 1.56-7.68; ≥ 7.0 mg/dL, HR 2.05, 95%CI 1.21-3.48). Adjusted HR lost its significance at 6.0 mg/dL. The adjustment for the logit of the propensity scores showed the similar results but with worse model fittings than the stratification method. Upon further adjustment for other covariates the significance was attained at 6.5 mg/dL.
conclusionsThree different methods of the propensity score analysis showed consistent results that the higher UA accelerates the progression to the subsequent ESRD. A stratified Cox regression outperforms other methods in generalizability and adjusting for residual bias. Serum UA should be targeted less than 6.5 mg/dL.
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