Original investigationsPathogenesis and treatment of kidney disease and hypertensionSignificance of hyperuricemia as a risk factor for developing ESRD in a screened cohort
Section snippets
Study design
All subjects older than 20 years who participated in the 1993 mass health screening examinations in Okinawa, Japan, were eligible for the study. The population in 1993 was approximately 1.24 million. Screening participants were excluded from the present study if birth date or serum uric acid data were not available from the registry files. Dialysis patients who were among the 1993 screening participants and individuals who had become dialysis patients during the study period through December
Results
Baseline characteristics of screenees with data for serum uric acid level are listed in Table 1. Mean age at screening was 52.2 ± 15.6 years. The distribution of baseline levels of serum uric acid is shown in Fig 1. Mean serum uric acid level was 5.5 ± 1.5 mg/dL (327 μmol/L): 6.4 ± 1.4 mg/dL (381 μmol/L) for men and 4.8 ± 1.1 mg/dL (286 μmol/L) for women. Serum uric acid levels were greater in men than women in all age groups (Fig 2). Levels increased with age in women 51 years and older.
Discussion
The present study aims to investigate the relationship between baseline serum uric acid level and the development of ESRD by using a relatively large screening in a general population in Okinawa, Japan. Results show the significance of hyperuricemia on developing ESRD, particularly in women. Renal outcomes of gout and hyperuricemia have been considered not significant.16, 17 However, it recently was reappraised that hyperuricemia may be directly pathogenic and is not only a marker for other
Acknowledgment
The authors thank the staff of the OGHMA, in particular, M. Itokazu and K. Shiroma, for retrieving data files from the 1993 health check; Dr O. Morita for help with data processing and statistical analysis; and the physicians and co-medical staff of all dialysis units in Okinawa for their collaboration. The following doctors gave invaluable advice, support, and encouragement: T. Minei, T. Kowatari, K. Nishime, H. Ogimi, T. Yonaha, C. Mekaru, K. Kinjo, M. Nakayama, H. Uehara, H. Sunagawa, S.
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Supported in part by grants from the Ministry of Health and Welfare of Japan.