Habitual alcohol intake modifies relationship of uric acid to incident chronic kidney disease

Previous studies showed that higher serum uric acid levels increased the risk of chronic kidney disease (CKD), but moderate alcohol consumption decreased it. The comparative importance of serum uric acid levels and habitual alcohol consumption as risk factors for chronic kidney disease remain undefined. Researchers therefore evaluated the relationship of baseline serum uric acid level in combination with daily alcohol consumption to the incidence of chronic kidney disease.
The prospective cohort study included 9,116 middle-aged nondiabetic Japanese men without chronic kidney disease or proteinuria who were not taking antihypertensive medications nor urate- lowering medications at entry. Chronic kidney disease was defined as estimated glomerular filtration rate <60 mL/min/1.73 m2. The study investigated the relationship of baseline serum uric acid level in combination with daily alcohol consumption to the incidence of chronic kidney disease during an 11-year observation period. Daily alcohol consumption was classified into 4 groups: nondrinkers, light drinkers (0.1-23.0 g ethanol/ day), moderate drinkers (23.1-46.0 g ethanol/day), and heavy drinkers (≥46.1 g ethanol/day).
During the 79,361 person-years follow-up period, a total of 1,230 subjects developed chronic kidney disease. Higher serum uric acid levels increased
risk of chronic kidney disease; and moderate daily alcohol consumption decreased the risk. Multiple- adjusted hazard ratios of chronic kidney disease were 1.38 (95% CI 1.11-1.70), 1.58 (95% CI 1.28-1.95),
2.27 (95% CI 1.86-2.77), and 3.12 (95% CI 2.56-3.81)
for quintile 2, quintile 3, quintile 4, and quintile 5 of serum uric acid levels, respectively, compared with quintile 1, and that for moderate drinkers was 0.55 (95% CI 0.46-0.66) compared with nondrinkers. In the joint analysis of alcohol consumption and serum uric acid, moderate drinkers with the lowest tertile of serum uric acid levels had the lowest risk of chronic kidney disease, but nondrinkers with the highest tertile of serum uric acid levels had the highest risk of chronic kidney disease.
The authors conclude that in the joint analysis of alcohol consumption and serum uric acid, moderate drinkers with the lowest tertile of serum uric acid levels had the lowest risk of chronic kidney disease. Serum uric acid level and daily alcohol consumption were independently associated with the risk of chronic kidney disease. Non drinkers with the highest serum uric acid level had the highest risk of chronic kidney disease.
Source: Habitual alcohol intake modifies relationship of uric acid to incident chronic kidney disease. Okada Y, Uehara S, Shibata M, Koh H, Oue K, Kambe H, Morimoto M, Sato KK, Hayashi T. Am J Nephrol. 2019 Jun 6:1-8.