Synergistic interaction of hyperuricemia and hypertension on reduced eGFR: insights from a general Chinese population

Postgrad Med. 2020 Apr;132(3):263-269. doi: 10.1080/00325481.2020.1718387. Epub 2020 Jan 30.

Abstract

Objectives: Hyperuricemia and Hypertension are two independent risk factors of renal function damage. Our research aimed to investigate the synergistic interaction between hyperuricemia and hypertension toward reduced eGFR.

Methods: Our analyses included 11,694 participants from a cross-sectional population-based Northeast China Rural Cardiovascular Health Study. Interaction was assessed on both multiplicative and additive scales.

Results: The prevalence of reduced estimated glomerular infiltration rate (eGFR) was 2.11% in our population. After adjustment of age, sex, race, education level, family income, current smoking and drinking status, body mass index, total cholesterol, high-density lipoprotein cholesterol, and diabetes, subjects with both hyperuricemia and hypertension suffered from a 11.004 (95% CI: 7.080-17.102) times risk of reduced eGFR than the healthy reference group, greater than that in participants with only hyperuricemia (5.741, 95% CI: 3.045-10.825) or hypertension (1.145, 95% CI: 0.764-1.715). Furthermore, additive interaction between hyperuricemia and hypertension was statistically significant and synergistic (relative excess risk due to interaction: 5.118, 95% CI: 0.611-9.624; the attributable proportion due to interaction: 0.465, 95% CI: 0.151-0.779; Synergy index: 2.047, 95% CI: 1.017-4.120). However, our results revealed no significant interaction on the multiplicative scale.

Conclusions: Hyperuricemia and hypertension may have a synergistic interaction toward renal function loss in addition to their independent impacts. Our findings may provide a straightforward illustration which is easy for the public to realize the hazard of coexistent hypertension and hyperuricemia on renal injury.

Keywords: Chronic kidney disease; hypertension; hyperuricemia; synergistic interaction.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Asian People
  • Body Mass Index
  • China / epidemiology
  • Cross-Sectional Studies
  • Female
  • Glomerular Filtration Rate / physiology*
  • Health Behavior
  • Humans
  • Hypertension / epidemiology*
  • Hyperuricemia / epidemiology*
  • Kidney Diseases / epidemiology*
  • Logistic Models
  • Male
  • Middle Aged
  • Risk Factors
  • Sex Factors
  • Socioeconomic Factors