Uric Acid Excretion Scores And Renal Tubular Function Damage Of Correlation Analysis

Objective:To compare the parameters of renal uric acid handling in patients with chronic kidney disease, and analyse which is the priority. Then to study the correlation between fractional excretion of uric acid (FEUr) and renal tubular damage.Methods:Patients with chronic kidney disease in Nephrology ward in our hospital was collected, Measures of kidney function were estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease Study (MDRD) equation. The patients were categorized into two groups, one was eGFR≧60(ml·min-1·(1.73m2)-1)),the other was eGFR<60(ml·min-1·(1.73m2)-1). every group was divided into3groups according to the levels of serum uric acid(SUA)(>350umol/L、250umol/L-350umol/L、<250umol/L), SUr、serum creatinine (SCr)、24-h urinary creatinine (24h UCr)and uric acid (24hUUr)were measured. fractional excretion of uric acid (FEUr), uric acid clearance (Cur), excretion of uric acid per volume of glomerular filtration (EurGF), urinary uric acid to creatinine ratio(UUr/UCr) were calculated. Then analyse the relationship between urine N-acetyl-B-d-glucosaminidase (NAG) and FEUr. Selected20healthy subjects as control group.Results:The patients’body mass index(BMI)、systolic blood pressure (SBP)、and SCr increased with SUr, and were statistically different among3groups segregated by SUr in patients with eGFR≧60(ml·min-1·(1.73m2)(P=0.003; P<0.05; P=0.001).while free plasma glucose(FPG)、eGFR、FEUr、Cur、UUr/Ucr decreased (P=0.002、P<0.05、P=0.003、P<0.05、P<0.05、P<0.05). Spearman correlation showed that Sur was correlated negatively with FEUr、Cur、UUr/Ucr.(r=-0.779, P<0.05;r=-0.632, P<0.05;r=-0.402, P=0.001). Spearman correlation showed NAG was positively correlated with FEUr (r=0.57, P<0.05) in patients with eGFR≧60(ml·min-1·(1.73m2).The patients’Scr increased with Sur. and were statistically different among3groups segregated by SUr in patients with eGFR≧60(ml·min-1·(1.73m2)(P=0.036) Spearman correlation indicated that Sur was correlated negatively with Cur、UUr/Ucr、24hUUr, FEUr ((r=-0.677, P<0.05; r=-0.505, P<0.05;r=-0.396, P=0.001; r=-0.364, P=0.003). and Spearman correlation showed NAG was no correlated with FEUr in patients with eGFR<60(ml·min-1·(1.73m2).Conclusion:The parameters of renal uric acid handling in patients with eGFR≧60(ml min-1·(1.73m2) are FEUA、Cur、UUA/Ucr, FEUA is the priority. and FEUr was positived correlated with renal tubular damage. The parameters of renal uric acid handling in patients with eGFR<60(ml·min-1·(1.73m2) are24hUUr、Cur、UUr/Ucr, and UUr is better than other parameters. FEur is uncorrelated with renal tubular damage,maybe effected by reduced glomerular filtration rate.