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Open AccessArticle

The Effects of Hyperuricemia on the Prognosis of IgA Nephropathy are More Potent in Females

1
Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju 61469, Korea
2
Department of Internal Medicine and Research Institute of Clinical Medicine of Chonbuk National University-Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju 54907, Korea
3
Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Korea
4
Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Korea
*
Authors to whom correspondence should be addressed.
These authors have contributed equally to this manuscript as correspondence authors.
J. Clin. Med. 2020, 9(1), 176; https://doi.org/10.3390/jcm9010176 (registering DOI)
Received: 5 December 2019 / Revised: 26 December 2019 / Accepted: 7 January 2020 / Published: 8 January 2020
(This article belongs to the Section Nephrology & Urology)
Hyperuricemia is a potential risk factor for immunoglobulin A nephropathy (IgAN) progression but its sex-specific effects on IgAN progression remain unclear. This study aimed to determine the effect of serum uric acid on IgAN progression and whether its effect varied according to sex. A total of 4339 patients who diagnosed with IgAN by renal biopsy were retrospectively analyzed. We assessed the association of serum uric acid on IgAN progression using Kaplan–Meier survival analyses and Cox proportional hazards models. The study’s primary end point was IgAN progression that was defined as a 50% decline in the estimated glomerular filtration rate or the initiation of dialysis. On average, the serum uric acid levels were higher in the men than in the women. In the fully adjusted Cox proportional hazards model that considered all subjects, the risk of IgAN progression increased by about 25.6% for every 1 mg/dL increase in the baseline uric acid level. The serum uric acid level was an independent risk factor for IgAN progression in both sexes but its effect was more pronounced in the women (hazard ratio [HR], 1.383; confidence interval [CI],1.263 to 1.514; p < 0.001) than in the men (HR, 1.181; CI, 1.097 to 1.272; p < 0.001) (pinteraction < 0.001). A sensitivity analysis involving serum uric acid quartiles generated consistent and robust results. In conclusion, the serum uric acid level was an independent risk factor for IgAN progression and its effect was more pronounced among the women compared with that among the men. View Full-Text
Keywords: Ig A nephropathy; hyperuricemia; uric acid; glomerulonephritis; renal outcome; female; disease progression; prognosis; risk factor; sex Ig A nephropathy; hyperuricemia; uric acid; glomerulonephritis; renal outcome; female; disease progression; prognosis; risk factor; sex
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Oh, T.R.; Choi, H.S.; Kim, C.S.; Kang, K.P.; Kwon, Y.J.; Kim, S.G.; Ma, S.K.; Kim, S.W.; Bae, E.H. The Effects of Hyperuricemia on the Prognosis of IgA Nephropathy are More Potent in Females. J. Clin. Med. 2020, 9, 176.

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