Introduction:
CKD is associated with metabolic disturbances like hypertension, impaired glycaemic control, hyperuricemia, dyslipidemia and malnutrition. Recent studies have focused on using lipid parameters and lipid ratios as biomarkers in detecting early renal dysfunction and as a predictor of morbidity and mortality. Uric acid is being linked to metabolic syndrome and as a marker of endothelial injury.
In our study we estimated uric acid levels and lipid profile in nondiabetic CKD patients. We aimed to find correlation between uric acid levels and lipid ratios in non-diabetic CKD patients.
Methods:
Cross sectional, observational hospital-based study. 250 non diabetic CKD patients >18 yrs were enrolled. Patients on dialysis, acute kidney injury, on urate lowering agents, on lipid lowering therapy and diabetics were excluded.
Defining variables:
Hyperuricemia was defined as Serum uric acid ≥7 mg/dl. Dyslipidaemia was defined according to NCEP ATP-III criteria.
For Lp(a) >30mg/dl, ApoB >105mg/dl and ApoA1 <122mg/dl we referred to kit ranges.
For LDL/HDL and ApoB/Apo A1 upper limit of 3 and 0.8 respectively were taken for cardiovascular risk. Log TG/HDL i.e., Atherogenic Index of Plasma (AIP) >0.21 was considered high risk for cardiovascular disease.
Results:
Among the study subjects, 13.2%, 14.0%, 29.2% ,19.6% and 24.0% of the participants had CKD Stage G1, G2, G3, G4and G5 respectively.
The mean of Uric Acid was 7.45 ±2.50mg/dl. Hyperuricemia was observed in 130 (52%) patients with majority of patients being in CKD stage 5 (33.1%).
Overall prevalence of dyslipidemia was observed in 82.8%. High VLDL, TG, TC, Non-HDL, LDL and reduced HDL was observed in 58.8%,57.2%,27.6%,24%,22.4% and 52.8% respectively.
Novel markers of cardiovascular risk like reduced apoA1 was seen in 48.8% patients, raised APO B 32.8% patients, increased Lp(a) in 44% patients.
Mean TC/HDL, LDL/HDL, Non-HDL/HDL, ApoB /ApoA1was highest in CKD stage 1; whereas TG/HDL and log TG/HDL being highest in CKD stage 2. Decreasing trend was observed with progressive stages.
Increased TC/HDL, TG/HDL, LDL/HDL, ApoB/ApoA1and LogTG/HDL i.e. Atherogenic index of plasma (AIP) was observed in 39.6%, 66.2%,33.2%, 48.4% and 90.4% patients respectively.
A significant negative correlation between Uric Acid (mg/dL) and eGFR (p = <0.001).
For CKD stages ≥3, a significant positive correlation was obtained between eGFR and TC, LDL, Non- HDL, ApoA1, ApoB and LDL/HDL ratio. A significant negative correlation was observed between eGFR and Lp(a).
A positive correlation was observed between uric acid and TC/HDL, TG/HDL, Non-HDL/HDL and Log TG/HDL and significant inverse correlation was observed between uric acid and TC, HDL and ApoA1 across all stages.
For CKD stage ≥3, inverse correlations were observed between uric acid and HDL and ApoA1. Among lipid ratios positive correlations were observed between uric acid and TC/HDL, TG/HDL, LDL/HDL, Non-HDL/HDL, ApoB/ApoA1 and Log TG/HDL for CKD stage ≥3 which were statistically significant.
Conclusions:
Uric acid levels were inversely associated with eGFR.
Lipid abnormality was observed in all stages of CKD with increased triglycerides, VLDL, Lp(a) and reduced HDL and Apo1 which contributes to cardiovascular risk.
Uric acid is found to be associated with HDL, Apo1, TC/HDL, TG/HDL, LDL/HDL, ApoB/Apo A1 and log TG/HDL ratio.
We conclude that Uric acid might be a contributing factor for development of dyslipidemia and increased cardiovascular risk.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.