Hyperuricemia in Chronic Kidney Disease: Frequency and Clinical Associations at Ayub Teaching Hospital Abbottabad

Abstract

Background: Chronic kidney disease (CKD) is a major public health burden in low- and middle-income countries, including Pakistan, where prevalence is estimated at 21–30%. Hyperuricemia, traditionally considered a consequence of impaired renal clearance, is increasingly recognized as a potential contributor to CKD progression and cardiovascular risk. However, local data on its frequency and clinical associations remain scarce. Objective: To determine the prevalence of hyperuricemia and its clinical associations among hospitalized CKD patients at a tertiary care hospital in Pakistan. Methods: A descriptive cross-sectional study was conducted at Ayub Teaching Hospital, Abbottabad, from January to June 2025. A total of 192 patients aged 20–70 years with confirmed CKD were enrolled through consecutive sampling. Demographic, clinical, and laboratory data were collected, including serum uric acid (SUA), serum creatinine, and eGFR. Hyperuricemia was defined as SUA >7.2 mg/dL. Associations with clinical variables were assessed using Chi-square, correlation, and logistic regression. Results: The mean age was 54.2 ± 11.8 years; 57.3% were male and 63.0% rural residents. Hyperuricemia was observed in 47.9% (95% CI: 40.9–55.0). It was significantly associated with hypertension (OR 1.76, p = 0.04), showed a trend with dialysis (OR 1.68, p = 0.07), and inversely correlated with education (OR 0.49, p = 0.04). SUA correlated negatively with eGFR (r = –0.41, p < 0.001) and positively with BMI (r = +0.18, p = 0.01). Conclusion: Hyperuricemia is highly prevalent among CKD patients in Pakistan and independently associated with hypertension, lower education, and declining renal function. Routine monitoring and targeted management may improve outcomes in high-risk groups.