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

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

Key-points

• Hypertension and hyperuricemia were independently associated with reduced renal function;

• Hypertension and hyperuricemia acted synergistically towards reduced eGFR;

• 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.

Declaration of interest

The authors report no relationships that could be construed as a conflict of interest.

Additional information

Funding

This study was supported by grants from the ‘Thirteenth Five-Year’ program funds (The National Key Research and Development Program of China, Grant #2017YFC1307600). The National Key Research and Development Program from the Ministry of Science and Technology of China (Project Grant # 2018YFC1312400, Sub-project Grant # 2018YFC1312403). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.