Journal of Health Care Communications Open Access

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Multiplicative and Additive Interactions of Hyperuricemia and Hypertension on the Risk of Chronic Kidney Disease: Evidence from a Prospective Population-Based Cohort Study

Zhibin Ma, Xiaobin Hu*, Ping Hu, JunLing Shi, Yajjun Wang, Yingli Tian, Hong Liu, Feng Xu and Mengli Nan

Objective: To investigate the association between hyperuricemia (HUA) and the risk of Chronic Kidney Disease (CKD) in the Jinchang cohort and the interaction between HUA and hypertension on the risk of CKD, in order to provide a scientific basis for the prevention and treatment of CKD.

Methods: Based on the Jinchang cohort, a Cox regression model was applied to investigate the association between HUA and the risk of CKD using the non-HUA population as a reference, and HR values (95% CI) were calculated. According to the baseline age (<45 years, 45 years-64 years, ≥ 65 years), gender (male, female), BMI (<24.0 kg.m-2, 24.0 kg.m−2-27.9 kg.m-2, ≥ 28.0 kg.m-2), smoking (no, yes, quit smoking), alcohol consumption (no, yes, quit drinking, the study population diabetes (no, yes) hypertension (no, yes) and occupation (worker, other) were analyzed by subgroups. The product term of HUA and hypertension was also added to the Cox regression model to test whether there was a multiplicative interaction between the association of HUA and hypertension with the risk of developing CKD. The additive interaction between HUA and hypertension on the risk of developing CKD was examined using SAS macros, and the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and The results showed that after adjusting for the confounding factors, the H-risk ratio was higher than the RERI.

Results: After adjusting for confounders, there was an association between HUA and the risk of developing CKD, with the risk of CKD in the HUA population being 1.28 times higher than in the non-HUA population (HR=1.28, 95% CI:1.12-1.47). This association was more pronounced in the age ≥ 65 years, female, BMI <24 kg.m-2, ex-smoker, worker, non-diabetic and hypertensive populations. The interaction results showed a positive multiplicative and additive interaction between HUA and hypertension on the risk of developing CKD. The product term INTM (95% CI) for HUA and hypertension was 1.33 (1.01-1.77); the additive interaction evaluation indexes RERI (95% CI), AP (95% CI), and SI (95% CI) were 0.64 (0.21-1.07), 0.27 (0.11-0.43), and 1.93 (1.16-3.19), respectively.

Conclusion: HUA is a risk factor for the development of CKD and has a synergistic effect with hypertension on the development of CKD. For the early prevention and treatment of CKD, the focus should be on and intervention for those with HUA combined with hypertension, so that the limited health resources and funds can be used rationally to the maximum extent.

Published Date: 2024-12-01; Received Date: 2023-12-04