ObjectiveTo investigate the association between serum uric acid (SUA) level and body mass index (BMI) on the development of chronic kidney disease (CKD) in working men aged 20–60 years.DesignRetrospective cohort study.SettingData from employees’ annual health check-ups were collected from two companies in 2009 and 2014.ParticipantsA total of 16 708 working men were recruited. We excluded participants with missing essential data (N=7801), who had basal estimated glomerular filtration rate (eGFR) 2 and/or proteinuria (N=698) or with the absence of follow-up data (N=2).Primary outcomeeGFR 2 and/or proteinuria (≥1+) in 2014 (defined as incident CKD).ResultsThe cut-off values of SUA for incident CKD were 6.6 mg/dL in both young (20–39 years old) and middle-aged (40–60 years old) men analysed by receiver operator characteristics. ORs for incident CKD were assessed on propensity score-matched (1:1) cohorts. In young participants (N=1938), after propensity score matching, a coexistence of high-level SUA (≥6.6 mg/dL) and overweight (BMI ≥25 kg/m2) was a significant risk factor of incident CKD (OR=2.18, 95% CI 1.10 to 4.31, p=0.025), but high-level SUA was not an independent risk factor without overweight status (p=0.174). In middle-aged participants (N=2944) after propensity score matching, high-level SUA was a significant risk factor of incident CKD both with or without overweight (OR=1.44, 95% CI 1.02 to 2.04, p=0.037; OR=1.32, 95% CI 1.01 to 1.73, p=0.041, respectively).ConclusionThese findings suggest that high-level SUA is strongly associated with incident CKD in overweight young adult men.