The prevalence of asymptomatic hyperuricemia in patients with chronic kidney disease and its effect on the course and prognosis (experience of one center)

Objective: to analyze the prevalence of asymptomatic hyperuricemia (HU), as well as to assess its relationship with metabolic disorders, pathological conditions and complications in chronic kidney disease (CKD), we conducted a retrospective cohort study in the form of a total cross-section of patients hospitalized in a round-the-clock bed of the nephrology department. Material and methods: 261 patients were included in the study, the average age was 50.9±17.2 (M±SD), there were 261 males and 99 females. The structure of CKD in hospitalized patients was as follows: CKD C1 — 53 patients, C2 — 70 patients, C3A — 46, C3B — 46, C4 — 36, C5 — 7 patients. The study did not include patients diagnosed with gout. Results: the uric acid level in the examined cohort was 369.8±109.7 mmol/L, ranging from 157 to 768 mmol/l. As the glomerular filtration rate (GFR) decreased, the probability of HU increased. With the development and progression of dyslipidemia, there was an increase in the probability of detecting HU. In patients with CKD, an increase in the level of daily proteinuria was also accompanied by an increase in the probability of detecting HU. The risk of progression of CKD to the terminal stages, as well as LVH, arrhythmias, hypertension is associated with high values of uric acid in the blood. Conclusions: the high prevalence of HU in patients with CKD, along with data on its negative impact on the course of CKD, is an important argument in favor of its detection and control. The association of HU with metabolic disorders against the background of high proteinuria explains one of the mechanisms of its detrimental effect on the course of CKD. The influence of HU on the probability of detection of hypertension, LVH, arrhythmias and terminal stages of CKD is shown, which determines the importance of the modifiability of this risk factor in the prognosis of the course of CKD