Development of Nephrolithiasis in Asymptomatic Hyperuricemia: A Cohort Study

Seolhye Kim, Yoosoo Chang, Kyung Eun Yun, Hyun Suk Jung, Soo Jin Lee, Hocheol Shin, Seungho Ryu

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Background Although the association between gout and nephrolithiasis is well known, the relationship between asymptomatic hyperuricemia and the development of nephrolithiasis is largely unknown. Study Design Cohort study. Setting & Participants 239,331 Korean adults who underwent a health checkup examination during January 2002 to December 2014 and were followed up annually or biennially through December 2014. Predictor Baseline serum uric acid levels of participants. Outcome The development of nephrolithiasis during follow-up. Measurements Nephrolithiasis is determined based on ultrasonographic findings. A parametric Cox model was used to estimate the adjusted HRs of nephrolithiasis according to serum uric acid level. Results During 1,184,653.8 person-years of follow-up, 18,777 participants developed nephrolithiasis (incidence rate, 1.6/100 person-years). Elevated uric acid level was significantly associated with increased risk for nephrolithiasis in a dose-response manner (P for trend < 0.001) in men. This dose-response association was not observed in women. In male participants, multivariable-adjusted HRs for incident nephrolithiasis comparing uric acid levels of 6.0 to 6.9, 7.0 to 7.9, 8.0 to 8.9, 9.0 to 9.9, and ≥10.0 mg/dL with uric acid levels < 6.0 mg/dL were 1.06 (95% CI, 1.02-1.11), 1.11 (95% CI, 1.05-1.16), 1.21 (95% CI, 1.13-1.29), 1.31 (95% CI, 1.17-1.46), and 1.72 (95% CI, 1.44-2.06), respectively. This association was observed in all clinically relevant subgroups and persisted even after adjustment for homeostasis model assessment of insulin resistance and high-sensitivity C-reactive protein level. Limitations Dietary information and computed tomographic diagnosis of nephrolithiasis were unavailable. Conclusions In this large cohort study, increased serum uric acid level was modestly and independently associated with increased risk for the development of nephrolithiasis in a dose-response manner in apparently healthy men.

Original languageEnglish
Pages (from-to)173-181
Number of pages9
JournalAmerican Journal of Kidney Diseases
Volume70
Issue number2
DOIs
StatePublished - 2017 Aug

Keywords

  • Korea
  • Nephrolithiasis
  • abdominal ultrasound
  • cohort study
  • hyperuricemia
  • kidney stone
  • risk factor
  • sex differences
  • uric acid
  • urinary stones

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