Uric acid and incident chronic kidney disease in dyslipidemic individuals

<b>Background:</b> Elevated uric acid (UA) is a recognized risk factor for chronic kidney disease (CKD). This study aimed to investigate whether this association exists in dyslipidemic patients receiving multifactorial treatment. <b>Methods:</b> An observational study conducted in Greece including 1,269 dyslipidemic individuals followed-up in a lipid clinic for ≥3 years. Estimated glomerular filtration rate (eGFR) was calculated by CKD-EPI equation and CKD was defined as ≤60 mL/min/1.73 m². The correlation was assessed between UA levels and the CKD risk after adjusting for potential confounding factors, after defining the following UA quartiles: Q1: &lt; 4, Q2: 4–5, Q3: 5–6, and Q4: &gt; 6 mg/dL. <b>Results:</b> After excluding patients with baseline eGFR &lt;60 mL/min/1.73 m², gout and those taking UA-lowering drugs, 1,095 individuals were eligible; of those, 91% and 69% were treated with statins and anti-hypertensive drugs, respectively. During their follow-up (6 years; IQR = 4–10), 11.9% of the subjects developed CKD, whereas the median annual eGFR decline was 0.69 mL/min/1.73 m² (IQR = 0.45–2.33). Multivariate analysis showed that baseline UA levels (HR = 1.26; 95% CI = 1.09–1.45, <i>p</i> = .001), female gender (HR = 1.74; 95% CI = 1.14–2.65, <i>p</i> = .01), age (HR = 1.10; 95% CI = 1.07–1.12, <i>p</i> &lt; .001), diabetes (HR = 1.67; 95% CI = 1.05–2.65, <i>p</i> = .03), cardiovascular disease (HR = 1.62; 95% CI = 1.02–2.58, <i>p</i> = .04), decreased baseline renal function (eGFR &lt;90 mL/min/1.73 m²) (HR = 2.38; 95% CI = 1.14–4.81, <i>p</i> = .02), and low-density lipoprotein cholesterol reduction (HR = 0.995; 95% CI = 0.991–0.998, <i>p</i> = .01) were associated with incident CKD. Additionally, patients with UA ≥6 mg/dL exhibited a higher risk of incident CKD compared with those in the lowest UA quartile (HR = 2.01; 95% CI = 1.11–3.65, <i>p</i> = .02). <b>Conclusion:</b> Higher UA levels are correlated with a higher risk of incident CKD in dyslipidemic individuals taking multifactorial treatment.