Research Article Kidney Dis Hyperuricemia and Impaired Renal Function: A Prospective Cohort Study Noppawit Aiumtrakul Puvanant Wiputhanuphongs Ouppatham Supasyndh Bancha Satirapoj Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand Received: July 21, 2019 Accepted: August 27, 2020 Published online: November 6, 2020 Noppawit Aiumtrakul Department of Medicine, Phramongkutklao College of Medicine Ratchawithi Rd., Thung Phaya Thai Bangkok 10400 (Thailand) tan.niie @me.com © 2020 The Author(s). Published by S. Karger AG, Basel karger@karger.com www.karger.com/kdd DOI: 10.1159/000511196 Keywords Glomerular filtration rate · Hyperuricemia Abstract Background: Related studies have demonstrated a relation- ship of elevated serum uric levels with a decline in kidney function. However, limited evidence exists in a Southeast Asian community-based population. Objective: The study aimed to examine the relationship between serum uric acid levels and impaired renal function. Methods: A prospective cohort study was conducted in the Thai army health checkup population between July 1, 2006 and December 31, 2012. Inclusion criteria included age older than 20 years and base- line estimated glomerular filtration rate (eGFR) over 60 mL/ min/1.73 m 2 . Cox regression analysis was used to evaluate the association between incidence of impaired renal func- tion and baseline serum uric acid quartiles. Impaired renal function was defined as eGFR <60 mL/min/1.73 m 2 over 3 months. Results: A total of 9,534 participants (7,474 men and 2,060 women) were enrolled. Cox regression analysis re- vealed a significant association of serum uric acid level with impaired renal function in the whole population as the un- adjusted hazard ratio (HR) (95% CI) of impaired renal func- tion in second, third, and fourth quartiles were 2.1 (1.39, 3.17), 2.39 (1.6, 3.59), and 3.94 (2.71, 5.74), respectively, when compared with serum uric acid in the first quartile, respec- tively. After adjusting in 2 models, the HR still significantly persisted with similar magnitudes in all quartiles. Higher in- cidences of impaired renal function were observed among males than among females in all quartiles. Kaplan-Meier curve showed better renal survival rate in the lower quartile groups. Linear regression analysis showed that eGFR nega- tively correlated with serum uric acid (r = -0.213, p < 0.001). Conclusion: Our study suggests that an independent asso- ciation exists of serum uric acid levels with the incidence of impaired renal function and renal progression in the South- east Asian community-based population. © 2020 The Author(s). Published by S. Karger AG, Basel Introduction CKD has been proven as a risk factor for cardiovascu- lar disease and mortality [1]. It has a high global preva- lence, causing high economic costs to health systems [2, 3], and CKD often progresses to ESRD, requiring renal Tis article is licensed under the Creative Commons Attribution- NonCommercial-NoDerivatives 4.0 International License (CC BY- NC-ND) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes as well as any dis- tribution of modifed material requires written permission.