Anemia and Hyperuricemia and New-Onset CKD

Worldwide, the incidence of chronic kidney disease (CKD) is on the increase. However, according to You-Chi Chen, MD, and colleagues there are few data available on the association between CKD and anemia and hyperuricemia. The hypothesis that anemia and hyperuricemia only influence renal outcomes in combination with other comorbidities is also controversial.

The researchers conducted a longitudinal study to examine those issues in a large Taiwanese cohort of 26,631 participants from the Taiwan Biobank. Results were reported in the International Journal of Environmental Research and Public Health [].

Individuals with CKD at baseline were excluded from the analysis. Eligible patients had follow-up data for a median of 4 years. CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m2. Incident new-onset CKD was defined as development of CKD during follow-up; anemia was defined as a hemoglobin level <13 mg/dL in men and <12 mg/dL in women; and hyperuricemia was defined as a serum uric acid level >7 mg/dL in men and >6 mg/dL in women.

The cohort was divided into four groups based on whether they had anemia and hyperuricemia. Results of multivariable analysis demonstrated significant associations between low hemoglobin (per 1 g/dL; odds ratio [OR], 0.760; P<.001) and high serum uric acid (per 1 mg/dL; OR, 1.444; P<.001) in model 1 and anemia (OR, 2.367; P<.001) and hyperuricemia (OR, 2.5126; P<.001) in model 2 with new-onset CKD.

Additionally, compared with the group without anemia or hyperuricemia, there were significant associations with new-onset CKD in the groups with anemia without hyperuricemia (OR, 2.502; P<.001), without anemia with hyperuricemia (OR, 2.559; P<.01), and with anemia and hyperuricemia (OR, 5.505; P<.001). There was a significant interaction between hemoglobin and serum uric acid and new-onset CKD (P<.001).

In conclusion, the authors said, “We found that anemia and hyperuricemia were associated with new-onset CKD, respectively, and also had a synergetic effect on new-onset CKD.”