Exploring the Predictors of Renal Function Among Adolescents: Analysis of Database Between 2011 and 2017

Friday, 20 July 2018

Li-Chiu Lin, MSN, RN1
Huan-Fang Lee, PhD, RN2
Yu-Rung Wang, MSN, RN3
Nai-Ying Liu, MSN, RN1
(1)Department of Nursing, National Tainan First Senior High School, Tainan City, Taiwan
(2)Nursing Department, National Cheng Kung University Hospital, Tainan city, Taiwan
(3)Department of Nursing, National Cheng Kung University, Tainan city, Taiwan


High uric acid in adolescence is prone to adult hyperuricemia and affects renal functions. Serum uric acid increases were positively associated with higher cardiovascular risk classes. Hyperuricemia may be related to the increase of obesity and metabolic syndrome in recent decades. The majority (90%) of people with hyperuricemia do not have any symptoms, and approximately 10% of them will eventually become gout patients. Research investigated the connection between hyperuricemia and CKD progression in over 600 children and found that increased levels of uric acid were predictive of a more rapid decline in kidney function.

Adolescents in Taiwan have excessive dietary intake of sugar from sugary drinks and refined foods that lead to unbalanced diet, and along with less exercise, that can result in obesity, one of the major health worries on campus. Research results showed that 30.8% of senior high school students were overweight and obese, of which the ratio of male students was 32.3% while that of female students was 29.0%. Overweight and obesity make it easy for the adolescents to be prone to chronic diseases, causing increased medical costs. The level of uric acid is affected by the diet, and the risk factors for high uric acid include high blood sugar, low HDL, obesity and high blood pressure. Adolescents with asymptomatic hyperuricemia are 3.99 times as likely to develop chronic diseases as general population after adolescence; therefore, the control of asymptomatic hyperuricemia is an important issue. Due to the fact that most studies focused on the high uric acid and renal function among adults, little research explored the abnormal renal functioning caused by the life style among adolescents. Therefore, the purpose of this study was to explore the predictors of renal function among male adolescents by analyzing the student health checkup database between 2011 and 2017.


This study applied a retrospective research design, and the source of data was from the health checkup database of 5,232 male freshmen between 2011 and 2017. The variables for analysis included blood pressure, waist circumference, uric acid, BMI, TG, HDL-C, and Creatinine. The renal function was calculated with the MDRD formula, with the eGFR as the dependent variable. Descriptive statistics, Pearson product-moment correlation, and logic regression were utilized for data analysis.


The average age of the subjects was 15.3 years old. In terms of the physical examination results, the average BMI was 21.47±3.87㎏/m2, average systolic blood pressure 124.60±12.51mmHg, average diastolic blood pressure 70.44±8.75mmHg, average waist circumference 73.62±10.02mg/dL, average uric acid level 6.78±1.17 mg/dL, triglyceride 101.97±55.66, average HDL-C 55.05±11.45mg/dL, and average GFR 104.97±14.70. There showed positive correlation between uric acid and systolic blood pressure, diastolic blood pressure, BMI, waist circumference, TG, HDL, and GFR (r = 0.15~0.42, p = 0.00). The predictors of renal function among male adolescents were BMI, uric acid, and waist circumference. The risk of renal dysfunction increased by 11.6% for each additional unit of BMI (OR = 1.116) (P < .001, CI 1.059 to 1.175). The risk of renal dysfunction increased by 46.8% for each additional uric acid level (OR =1.468) (P < .001, CI 1.362 to 1.583).


BMI, uric acid, and waist circumference can predict the renal function among male adolescents. It is recommended that schools should pay special attention to the dietary patterns and fitness status of male adolescents to avoid diets that cause obesity and high uric acid so as to promote health of male adolescents.