Background Cohort studies evaluating increased serumuric acid (SUA) level as a chronic kidney disease (CKD)risk factor have yielded variable results. We aimed toassess the association between the pattern of longitudinalchanges in SUA and incident CKD [estimated glomerularfiltration rate (eGFR)\60 ml/min/1.73 m2].Methods A population-based cohort study was conductedon 3,605 participants who were followed prospectively fora mean of 5.18 years. The longitudinal changes in SUAwere categorized into three subgroups: persistently low,fluctuated (reduced or elevated), and persistently high. Theprimary outcome of interest was the development of CKDat a follow-up examination. Cox proportional hazardsanalysis was used to test the hypothesis.Results After adjustment for potential confounders, participantswith fluctuated SUA with progressively elevated
level and persistently high SUA level had significantl