Relationship of Serum Uric Acid with Kidney Function Decline Mediated by Systemic Arterial Stiffness: A Retrospective Cohort Study in Japan

Figures

• 

  Figure 1. Relationship of adjusted hazard ratio for KFD with stratified (A) CAVI and (B) SUA. Hazard ratios with 95% confidence interval are shown. * Significant increase in hazard ratio versus the lowest stratum as the control group. p values for trend were estimated using Wald test. Hazard ratios were adjusted for age, sex, BMI, SBP, FPG, LDL-C, HDL-C, ln(TG), current smoking, proteinuria, and the treatment of gout and/or hyperuricemia. KFD was defined as a decrease in eGFR to below 60 mL/min/1.73 m2 during the study period. HR, hazard ratio; KFD, kidney function decline; CAVI, cardio-ankle vascular index; SUA, serum uric acid; BMI, body mass index; SBP, systolic blood pressure; FPG, fasting plasma glucose; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; TG, triglycerides; and eGFR, estimated glomerular filtration rate.

• 

  Figure 2. Effects of the linkage between SUA and CAVI on the relationship of SUA with kidney function decline. (A) Association of SUA tiers with the incidence of KFD (%). * p < 0.001, Fischer’s exact test. (B) Hazard ratio for KFD per one SD increase in SUA. Hazard ratios (95% confidence interval) were adjusted for age, sex, BMI, SBP, FPG, LDL-C, HDL-C, ln(TG), current smoking, proteinuria, and the treatment of gout and/or hyperuricemia in Cox-proportional hazard analysis. KFD was defined as a decrease in eGFR to below 60 mL/min/1.73 m2 during the study period. Hyperuricemia was defined as SUA ≥ 4.5 mg/dL in females or ≥6.3 mg/dL in males. High CAVI was defined as CAVI ≥ 8.0 in males or ≥7.9 in females. KFD, kidney function decline; HR, hazard ratio; CAVI, cardio-ankle vascular index; SD, standard deviation; SUA, serum uric acid; BMI, body mass index; SBP, systolic blood pressure; FPG, fasting plasma glucose; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; TG, triglycerides; and eGFR, estimated glomerular filtration rate.

• 

  Figure 3. Mediation analysis of CAVI as a potential mediator for the association between SUA and KFD. KFD was defined as a decrease in eGFR to below 60 mL/min/1.73 m2 during the study period. Analysis was adjusted for confounding factors of older age (≥65 years), sex, BMI ≥ 25 kg/m2, hypertension, diabetes mellitus, dyslipidemia, the treatment of gout/hyperuricemia, current smoking, and proteinuria. KFD, kidney function decline; CAVI, cardio-ankle vascular index; SUA, serum uric acid; and BMI, body mass index. * p < 0.001, ** p < 0.05. β, standardized β coefficient.