Prevalence and associated factors of hyperuricemia in chronic kidney disease: evidence from a single-center hospital-based study in Ethiopia, 2024

Hyperuricemia has been implicated in accelerating the progression of chronic kidney disease (CKD). Identifying associated factors may help guide future interventions aimed at delaying CKD progression. To determine the prevalence of hyperuricemia and its associated factors among CKD patients. An institution-based cross-sectional study was conducted among adult CKD patients at the University of Gondar Comprehensive Specialized Hospital from September 2023 to January 2024. A total of 218 patients were enrolled using a consecutive sampling technique. Pretested, structured, interviewer-administered questionnaires were used to collect sociodemographic and clinical data. Data were entered using Epi Data Manager version 4.6 and analyzed with SPSS version 27.0. Multivariate logistic regression analysis was performed to identify factors associated with hyperuricemia, and variables with a p-value of less than 0.05 were considered statistically significant. The mean serum uric acid (SUA) level over the past 3 months was 7.76 mg/dL (SD ± 2.93). Among non-dialysis CKD patients (n = 189), 65.6% (95% CI: 58.7-72.0%) had hyperuricemia. Among all CKD patients (n = 218), the prevalence was 66.1%, and among dialysis patients (n = 29), it was 69.0%. Factors significantly associated with hyperuricemia among non-dialysis CKD patients were: male sex (AOR = 2.01; 95% CI: 1.01-4.28), serum triglyceride > 150 mg/dL (AOR = 4.05; 95% CI: 1.85-8.80), eGFR stage 4 (AOR = 6.31; 95% CI: 2.43-16.40), eGFR stage 5 (AOR = 4.62; 95% CI: 1.59-13.40), BMI 25-29.9 kg/m² (AOR = 4.12; 95% CI: 1.77-9.60), BMI ≥ 30 kg/m² (AOR = 6.24; 95% CI: 2.09-18.60), and 24-hour total urine protein > 3.5 g (AOR = 2.68; 95% CI: 1.10-6.52). This study found a high prevalence of hyperuricemia among non-dialysis CKD patients. Significant associated factors included male sex, high triglyceride levels, advanced CKD stages, elevated BMI, and heavy proteinuria. It highlights the importance of identifying individuals at higher risk of hyperuricemia for potential early interventions that may help delay CKD progression, and routine hyperuricemia screening may be considered in CKD patients with identified risk factors.