ArticleArthritis research & therapy2022
Association of acidic urine pH with impaired renal function in primary gout patients: a Chinese population-based cross-sectional study.
Article in Arthritis research & therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 33 citations in OpenAlex.
- Impact of adding urine alkalization therapy to xanthine oxidase inhibitor in gout management: a prospective cohort study.Rheumatology (Oxford, England) · 2025Trial
- Superiority of Low-Dose Benzbromarone Add-On to Low-Dose Febuxostat Compared With Febuxostat Monotherapy in Gout With Combined-Type Hyperuricemia.Arthritis care & research · 2024Trial
- Efficacy and safety of tart cherry supplementary citrate mixture on gout patients: a prospective, randomized, controlled study.Arthritis research & therapy · 2023Trial
- Recent advances of wearable electrochemical and optical sensors for sweat pH monitoring.RSC advances · 2026Review
- Effects of adding urinary alkalizer citrate mixture to febuxostat in gout patients with combined-type hyperuricemia and low urine pH: a prospective cohort study.Arthritis research & therapy · 2026Article
- The relationship between cardiometabolic index and hyperuricemia and gout in Korean adults: the 8th Korean National Health and Nutrition Examination Survey (2019-2021).Clinical rheumatology · 2026Article
- Effects of Citrate Mixture on Gout Flares During Urate-Lowering Therapy Initiation Among Chinese Male Underexcretion-Type Gout Patients: A Prospective Cohort Study.Journal of inflammation research · 2026Article
- Transdermal bicarbonate buffer therapy increases intratumoral pH and elicits antitumor responses in bladder cancer.Frontiers in immunology · 2026Article
- Controlled Fabrication of pH-Visualised Silk Fibroin-Sericin Dual-Network Hydrogels for Urine Detection in Diapers.Gels (Basel, Switzerland) · 2025Article
- Overexpression of Agr quorum sensing system in uropathogenic Staphylococcus aureus in response to simulated urinary metabolic conditions enhancing growth and virulence.Medical microbiology and immunology · 2025Article
- Article
- Comprehensive dietary patterns explain acquired cystic kidney disease risk through genetic and metabolomic mechanisms.Frontiers in nutrition · 2025Article
- Harnessing Nanotechnology for Gout Therapy: Colchicine-Loaded Nanoparticles Regulate Macrophage Polarization and Reduce Inflammation.Biomaterials research · 2024Article
- Increased risk of chronic kidney disease in uric acid stone formers with high neutrophil-to-lymphocyte ratio.Scientific reports · 2023Article
- Urine pH and imaging findings of prostate useful predictors of prolonged duration of hematospermia.Translational andrology and urology · 2023Article
- Oxalate Homeostasis in Non-Stone-Forming Chronic Kidney Disease: A Review of Key Findings and Perspectives.Biomedicines · 2023Review
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18 authors at 5 institutions in 4 countries.
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Abstract
backgroundPatients with gout frequently have low urinary pH, which is associated with the nephrolithiasis. However, the specific distribution of urinary pH and potential relationship of acidic urine pH to broader manifestations of kidney disease in gout are still poorly understood.
methodsA 2016-2020 population-based cross-sectional study was conducted among 3565 gout patients in the dedicated gout clinic of the Affiliated Hospital of Qingdao University to investigate the association between low urinary pH and kidney disease. We studied patients that we defined to have "primary gout", based on the absence of > stage 2 CKD. All subjects underwent 14 days of medication washout and 3-day standardized metabolic diet. We obtained general medical information, blood and urine biochemistries, and renal ultrasound examination on the day of the visit. The primary readouts were urine pH, eGFR, nephrolithiasis, renal cysts, microhematuria, and proteinuria. Patients were assigned into 5 subgroups (urine pH ≤5.0, 5.0 <pH≤ 5.5, 5.5 <pH< 6.2, 6.2 ≤pH≤ 6.9, and pH >6.9), aligning with the clinical significance of urine pH.
resultsOverall, the median urine pH and eGFR of all patients was 5.63 (IQR 5.37~6.09), and 98.32 (IQR 86.03~110.6), with acidic urine in 46.5% of patients. The prevalence of nephrolithiasis, microhematuria, and proteinuria were 16.9%, 49.5%, and 6.9%, respectively. By univariate analysis, eGFR was significantly associated with age, sex, duration of gout, tophus, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, serum utare, hypertension, diabetes, and urine pH. On multivariable analysis, eGFR was associated with age, sex, diastolic blood pressure, serum uric acid, hypertension, diabetes, and urine pH. Acidic urine pH, especially urine pH < 5.0, was significantly associated with the prevalence of kidney disease, including > stage 1 CKD, nephrolithiasis, kidney cyst, and microhematuria. Patients with 6.2 ≤ urine pH ≤ 6.9 and SU ≤ 480 μmol/L had the highest eGFR with the lowest prevalence of nephrolithiasis, microhematuria, and proteinuria.
conclusionsApproximately half of gout subjects had acidic urine pH. Urine pH < 5.0 was associated with significantly increased nephrolithiasis, renal cyst, microhematuria, and proteinuria. The results support prospective clinical investigation of urinary alkalinization in selected gout patients with acidic urine pH.
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