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Serum uric acid levels contribute to new renal damage in systemic lupus erythematosus patients

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Abstract

This study aims to determine whether uric acid levels contribute to new renal damage in systemic lupus erythematosus (SLE) patients. This prospective study was conducted in consecutive patients seen since 2012. Patients had a baseline visit and follow-up visits every 6 months. Patients with ≥2 visits were included; those with end-stage renal disease (regardless of dialysis or transplantation) were excluded. Renal damage was ascertained using the SLICC/ACR damage index (SDI). Univariable and multivariable Cox-regression models were performed to determine the risk of new renal damage. Uric acid was included as a continuous and dichotomous (per receiving operating characteristic curve) variable. Multivariable models were adjusted for age at diagnosis, disease duration, socioeconomic status, SLEDAI, SDI, serum creatinine, baseline use of prednisone, antimalarials, and immunosuppressive drugs. One hundred and eighty-six patients were evaluated; their mean (SD) age at diagnosis was 36.8 (13.7) years; nearly all patients were mestizo. Disease duration was 7.7 (6.8) years. Follow-up time was 2.3 (1.1) years. The SLEDAI was 5.2 (4.3) and the SDI 0.8 (1.1). Uric acid levels were 4.5 (1.3) mg/dl. During follow-up, 16 (8.6%) patients developed at least one new point in the renal domain of the SDI. In multivariable analyses, uric acid levels (continuous and dichotomous) at baseline predicted the development of new renal damage (HR 3.21 (1.39–7.42), p 0.006; HR 18.28 (2.80–119.48), p 0.002; respectively). Higher uric acid levels contribute to the development of new renal damage in SLE patients independent of other well-known risk factors for such occurrence.

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Author Contributions

All authors were involved in drafting or revising this article critically for important intellectual content, and all authors approved its final version. Drs. Manuel F. Ugarte-Gil and Cristina Reátegui-Sokolova have full access to all the data from the study and take responsibility for their integrity and the accuracy of the analyses performed.

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Authors and Affiliations

  1. Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Av. Grau 800, La Victoria, Lima 13, Lima, Peru

    C. Reátegui-Sokolova, Manuel F. Ugarte-Gil, Rocío V. Gamboa-Cárdenas, Francisco Zevallos, Jorge M. Cucho-Venegas, José L Alfaro-Lozano, Mariela Medina, Zoila Rodriguez-Bellido, Cesar A. Pastor-Asurza & Risto A. Perich-Campos

  2. Universidad Científica del Sur, Lima, Peru

    Manuel F. Ugarte-Gil

  3. Universidad Nacional Mayor de San Marcos, Lima, Peru

    Zoila Rodriguez-Bellido, Cesar A. Pastor-Asurza & Risto A. Perich-Campos

  4. School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA

    Graciela S. Alarcón

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  1. C. Reátegui-Sokolova
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  2. Manuel F. Ugarte-Gil
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  3. Rocío V. Gamboa-Cárdenas
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  4. Francisco Zevallos
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  5. Jorge M. Cucho-Venegas
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  6. José L Alfaro-Lozano
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  7. Mariela Medina
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  8. Zoila Rodriguez-Bellido
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Corresponding author

Correspondence to C. Reátegui-Sokolova.

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This work was partially supported by two institutional grants from EsSalud (1483-GCGP-ESSALUD-2013 and 1733-GCGP-ESSALUD-2014).

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Reátegui-Sokolova, C., Ugarte-Gil, M.F., Gamboa-Cárdenas, R.V. et al. Serum uric acid levels contribute to new renal damage in systemic lupus erythematosus patients. Clin Rheumatol 36, 845–852 (2017). https://doi.org/10.1007/s10067-017-3538-4

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  • DOI: https://doi.org/10.1007/s10067-017-3538-4

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