The role of systemic vascular involvement in mediating the association between serum uric acid (SUA) and renal function in hypertension and chronic kidney disease (CKD) has not been fully explored. The purposes of our study were: (1) to investigate the relationship between SUA with both carotid intima-media thickness (cIMT) and aortic pulse wave velocity (aPWV) in hypertensive subjects; (2) to assess the influence of renal function on these relationships; (3) to study whether systemic vascular changes may mediate the association between SUA and renal function in this population.Design and method:
We enrolled 523 hypertensive subjects with (n = 263) or without CKD (n = 260). The study was also conducted in the population divided into tertiles of SUA based on sex-specific cut-off values. cIMT was assessed by Duplex-Doppler ultrasonography and aPWV through oscillometric device.Results:
cIMT and aPWV were higher, and eGFR lower, in uppermost SUA-tertile patients when compared to those in the lowest ones (all p < 0.001) (Figure 1).Results:
Uricemia strongly correlated with eGFR, cIMT and aPWV at univariate analysis (p < 0.001) in all subjects, and with eGFR and cIMT after adjustment for confounders (p < 0.001). The relationships between SUA and cIMT were significant in both patients with or without CKD, in absence of significant differences between groups. Moreover, the adjustment of SUA for cIMT attenuated the relationship between SUA and eGFR (p = 0.019).Conclusions:
Systemic vascular changes related with SUA seem in part to mediate the association between SUA and renal function in hypertensive patients, regardless of kidney function.