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Significance of hyperuricemia and low urine pH as a risk factor for CKD in general health check population
Shigeko Hara, Hiroshi Tsuji, Yoshifumi Ubara＊, Megumi Miyagawa,
Satao Arimoto, Shiun Dong Hsieh
Toranomon Health Management center and Kidney Center＊
Toranomon Hospital, Tokyo, Japan

Background:
During the past recent years, there are many reports referring to the fact that uric acid is related to cardiovascular, renal disease and metabolic syndrome. However, there are no specifically clarified evidential studies between Uric acid and urine pH and CKD (Chronic kidney disease), which are considered important points for further investigation.

Methods:
General population who had check-ups at Toranomon Health Management Center during 1995- 2005 (11 years). 8676 (Male; 6571 Female; 2105) were selected for their first general health check-up in 1995, and had been re-visiting for about 3 times during 2 years and additional check-up in 2005. The relation of uric acid and urine pH with mean value on 3 times more on developing possible CKD during the span of 11 years was being investigated. CKD is defined under 60ml/min by estimated GFR.
The classification on levels of uric acid and urine pH in male and female are as follows 4 groups. Amongst male, with ranges of ﾒover 7.1 mg/dl: under 7.1 mg/dl ﾓ ; urine pH subclassified within the ranges of ﾒ over 6.5 and under 6.5 ﾓ. Amongst female, with ranges of ﾒover 5.1mg/dl, under 5.1mg/dl ﾓ ; urine pH subclassified within the ranges of same as male. Analyzed by Multivariate Cox proportional hazard analysis for the possible development of CKD during the span of past 11 years.

Results:
Amongst male, hyperuricemia and low urine pH group showed hazard ratio of 1.64 compared to low uric acid and high urine pH group, significantly showing the risk of developing CKD (p<0.0001). Amongst female, equivalent results were obtained; hazard ratio was 1.62 (p=0.0074).

Conclusion:
Hyperuricemia and low urine pH highly be considered as a very possible predictor to CKD. Lowering uric acid and alkalization of urine pH seems effective for prevention of CKD.

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