Serum Urate and Risk of Chronic Kidney Disease: A Mendelian Randomization Study Using Taiwan Biobank

Hsiao-Mei Tsao; Tai-Shuan Lai; Yi-Cheng Chang; Chia-Ni Hsiung; Yu-Hsiang Chou; Vin-Cent Wu; Shuei-Liong Lin; Yung-Ming Chen

doi:10.1016/j.mayocp.2023.01.004

Serum Urate and Risk of Chronic Kidney Disease: A Mendelian Randomization Study Using Taiwan Biobank

Mayo Clin Proc. 2023 Apr;98(4):513-521. doi: 10.1016/j.mayocp.2023.01.004. Epub 2023 Mar 3.

Authors

Hsiao-Mei Tsao¹, Tai-Shuan Lai², Yi-Cheng Chang³, Chia-Ni Hsiung⁴, Yu-Hsiang Chou¹, Vin-Cent Wu¹, Shuei-Liong Lin⁵, Yung-Ming Chen⁶

Affiliations

¹ Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
² Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: d99849016@ntu.edu.tw.
³ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
⁴ Data Science Statistical Cooperation Center, Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.
⁵ Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan.
⁶ Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital-Bei-Hu Branch, Taipei, Taiwan.

PMID: 36870858
DOI: 10.1016/j.mayocp.2023.01.004

Abstract

Objective: To evaluate the association between serum urate and risk of incident chronic kidney disease (CKD) and to assess whether serum urate plays a causal role in CKD.

Patients and methods: We conducted a prospective cohort study and Mendelian randomization analysis that analyzed longitudinal data from the Taiwan Biobank between January 1, 2012, and December 31, 2021.

Results: A total of 34,831 individuals met the inclusion criteria, of which 4697 (13.5%) had hyperuricemia. After a median (interquartile range) follow-up of 4.1 (3.1-4.9) years, 429 participants developed CKD. After adjustment for age, sex, and comorbid conditions, each mg/dL increase in serum urate was associated with a 15% higher risk of incident CKD (HR, 1.15; 95% CI, 1.08 to 1.24; P<.001). The genetic risk score and seven Mendelian randomization methods revealed no significant association between serum urate levels and the risk of incident CKD (HR, 1.03; 95% CI, 0.72 to 1.46; P=0.89; all P>.05 for 7 Mendelian randomization methods).

Conclusion: This prospective, population-based cohort study showed that elevated serum urate is a significant risk factor for incident CKD; however, Mendelian randomization analyses failed to provide evidence that serum urate had a causal effect on CKD in the East Asian population.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biological Specimen Banks
Cohort Studies
Humans
Mendelian Randomization Analysis
Prospective Studies
Renal Insufficiency, Chronic*
Risk Factors
Taiwan
Uric Acid*

Substances

Uric Acid