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

Objective: To evaluate the association between serum urate and risk of incident chronic kidney dis-ease (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 hyper-uricemia. 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; P1/40.89; 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. & COPY; 2023 THE AUTHORS. Published by Elsevier Inc on behalf of Mayo Foundation for Medical Education and Research. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Automated summary

This study aimed to evaluate the association between serum urate and the risk of incident CKD, and to assess whether serum urate plays a causal role in CKD. The results showed that each mg/dL increase in serum urate was associated with a 15% higher risk of incident CKD. However, Mendelian randomization analyses failed to provide evidence that serum urate had a causal effect on CKD in the East Asian population.