The time-averaged serum uric acid can better predict the prognosis of IgA nephropathy

To understand the clinical and pathological characteristics of patients with IgA nephropathy (IgAN) complicated by hyperuricemia, and to analyze the time-averaged SUA (TA-SUA) on the prognosis of IgAN. A retrospective analysis of 718 IgAN patients with diagnosis confirmed by renal biopsy and follow-up of more than 1 year was performed. At least two serum uric acid (SUA) levels were measured at intervals of 0.5–1 year during follow-up. The TA-SUA was calculated according to the area under the curve during the follow-up period. The primary endpoint of the study was the doubling of creatinine or end-stage renal disease. Four groups (Q1-Q4) were divided according to TA-SUA quartile spacing from low to high, and the association of the TA-SUA with prognosis in IgAN patients was assessed using Kaplan-Meier survival analysis and Cox proportional hazards models. This study included 718 patients with IgAN, of whom 181 (25.21 %) had hyperuricemia.Compared with the other three groups, the clinical and pathological characteristics of patients in the fourth quarter were more severe in both baseline SUA and TA-SUA groups. Multivariate results suggested that baseline SUA was not an independent risk factor for renal prognosis in IgAN patients after adjustment for clinical variables such as eGFR. High TA-SUA is an independent risk factor for renal prognosis in IgAN patients. Hyperuricemia is common in IgA nephropathy.High TA-SUA in IgAN patients show more severe clinical features and pathological damage. TA-SUA is an independent risk factor for renal prognosis in IgA nephropathy patients. •Our study demonstrated that high SUA levels correlate with severity of clinical symptoms and pathological damage in IgAN patients.•This study analyzed the follow-up data, TA-SUA was identified as an independent risk factor for renal outcomes in patients with IgAN.•Compared to baseline SUA levels, TA-SUA provides a better prediction of renal outcomes in patients with IgA nephropathy.