Serum uric acid and renal prognosis in patients with IgA nephropathy

Background/Aims: This study was designed to elucidate the clinical signific ance of serum uric acid (SUA) and the relationship between hyperuricemia an d renal prognosis in IgA nepropathy. Methods: The correlation between SUA a nd other clinical parameters were examined in 748 IgA nephropathy patients (432 males and 316 females). Among these patients, 226 (144 males and 82 fe males) who were followed for more than 5 years were examined for the relati onship between hyperuricemia and renal prognosis. Results: In IgA nephropat hy, SUA correlated negatively with creatinine clearance (Ccr), and positive ly with urinary protein and tubulointerstitial damage. SUA was higher in pa tients with hypertension or diffuse proliferative glomerulonephritis. Hyper uricemia was a risk factor for renal prognosis, both in terms of serum crea tinine (p = 0.0025) and Ccr (p = 0.0057). In 56 patients with normal Ccr at renal biopsy, the change of Ccr after more than 8 years was -22.3 +/- 20.8 % in 13 patients with hyperuricemia, compared with +2.6 +/- 39.4% in 43 pat ients without hyperuricemia (p = 0.0238), Hyperuricemia was related indepen dently to deterioration of Ccr (p = 0.0461), Conclusion: Hyperuricemia in I gA nephropathy is derived from both glomerular and tubulointerstitial damag e, and correlated with hypertension. Hyperuricemia is a risk factor for ren al prognosis in IgA nephropathy. Copyright (C) 2001 S. Karger AG. Basel.