Association Of Hyperuricemia And Chronic Kidney Disease In Children

Objective:The purpose of this study is to evaluate the prevalence of hyperuricemia and elucidate the risk factors associated with hyperuricemia in childhood-onset chronic kidney disease.Method:We assessed the medical history,clinical data and follow-up data in 109 patients with chronic kidney disease in Department of Nephrology,Zhejiang University Children's Hospital from January 2013 to September 2018.85 children were recruited in the study finally.According to the level of uric acid,these 85 children were divided into two groups:hyperuricemia group(HUA)and non-hyperuricemia group(NUA).The data of the two groups were compared including age,gender,BMI,systolic blood pressure,diastolic blood pressure,urinary protein,24-hour urine protein,creatinine clearance,hemoglobin,albumin,creatinine,urea nitrogen,cholesterol,triglycerides,fibrinogen,D-dimers cystatin C,clearance of uric acid,fractional excretion of uric acid,eGFR,etiology,clinical stage,etc.The correlations between serum uric acid level and various parameters were examined.Result:There were 55 patients(64.7%)in HUA group and 30 patients(35.3%)in NUA group.Serum uric acid level were inversely correlated with clearance of uric acid(r=-0.440,P<0.01)and endogenous creatinine clearance(r=-0.371,P<0.05).And they were positively correlated with cystatin C(r=0.349,P<0.05).Logistic regression analysis indicated that clearance of uric acid,endogenous creatinine clearance and cystatin C were protective factors for hyperuricemia(OR=0.723,OR=0.887 and OR=0.040 respectively).Conclusion:The incidence of hyperuricemia in children with chronic kidney disease is high,and decreased glomerular filtration leads to the reduction of uric acid clearance.Hyperuricemia is an independent risk factor for the development of chronic kidney disease.