Tadej Petreski1, Robert Ekart2,3, Radovan Hojs4,3, Sebastjan Bevc4,3. 1. Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia. tadej.petreski@gmail.com. 2. Department of Dialysis, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia. 3. Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia. 4. Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia.
Abstract
PURPOSE: Hyperuricemia has been associated with higher mortality in the general population, but less is known about CKD patients. The aim of our study was to determine the impact of elevated serum uric acid on cardiovascular mortality of CKD patients who later progress to hemodialysis. METHODS: In this retrospective study, 120 CKD patients (entire population of patients with ESKD on January 1st, 2012) were observed from their first visit at the Nephrology outpatient clinic, while transitioning to hemodialysis, and until their death or January 1, 2016. After non-cardiovascular death exclusion, 83 CKD patients (33 female, 50 male) were left for further analysis. The average time of observation was 8.8 ± 4.2 years. Serum uric acid was measured regularly (every 3 months). No patients were treated for hyperuricemia. Mean uric acid of 420 µmol/L was set as a cut-off between normouricemic and hyperuricemic patients as per the laboratory's reference values. Survival rates were analyzed using Kaplan-Meier survival curves. Three Cox regression models were used to assess the influence of uric acid on survival. RESULTS: Mean uric acid was 379.8 ± 71.6 µmol/L (range 220-574). Sixty-three (75.9%) patients were normouricemic and 20 (24.1%) were hyperuricemic. Cholesterol was the only variable to show statistically significant difference (p = 0.004) between the groups. Bivariate analysis revealed an association between death and age, hyperuricemia, arterial hypertension, and history of cardiovascular disease. Kaplan-Meier survival analysis showed higher risk of cardiovascular death for hyperuricemic patients (log rank test; p < 0.0005). In Cox regression models, hyperuricemia remained a predictor of cardiovascular mortality (SE = 0.500, Exp(B) = 14.120, 95% CI 5.297-37.640) in our patients next to age and arterial hypertension. CONCLUSION: The results indicate an association between hyperuricemia and cardiovascular mortality in CKD patients who transition to hemodialysis.
PURPOSE:Hyperuricemia has been associated with higher mortality in the general population, but less is known about CKDpatients. The aim of our study was to determine the impact of elevated serum uric acid on cardiovascular mortality of CKDpatients who later progress to hemodialysis. METHODS: In this retrospective study, 120 CKDpatients (entire population of patients with ESKD on January 1st, 2012) were observed from their first visit at the Nephrology outpatient clinic, while transitioning to hemodialysis, and until their death or January 1, 2016. After non-cardiovascular death exclusion, 83 CKDpatients (33 female, 50 male) were left for further analysis. The average time of observation was 8.8 ± 4.2 years. Serum uric acid was measured regularly (every 3 months). No patients were treated for hyperuricemia. Mean uric acid of 420 µmol/L was set as a cut-off between normouricemic and hyperuricemicpatients as per the laboratory's reference values. Survival rates were analyzed using Kaplan-Meier survival curves. Three Cox regression models were used to assess the influence of uric acid on survival. RESULTS: Mean uric acid was 379.8 ± 71.6 µmol/L (range 220-574). Sixty-three (75.9%) patients were normouricemic and 20 (24.1%) were hyperuricemic. Cholesterol was the only variable to show statistically significant difference (p = 0.004) between the groups. Bivariate analysis revealed an association between death and age, hyperuricemia, arterial hypertension, and history of cardiovascular disease. Kaplan-Meier survival analysis showed higher risk of cardiovascular death for hyperuricemicpatients (log rank test; p < 0.0005). In Cox regression models, hyperuricemia remained a predictor of cardiovascular mortality (SE = 0.500, Exp(B) = 14.120, 95% CI 5.297-37.640) in our patients next to age and arterial hypertension. CONCLUSION: The results indicate an association between hyperuricemia and cardiovascular mortality in CKDpatients who transition to hemodialysis.
Authors: Lindsay N Helget; Bryant R England; Punyasha Roul; Harlan Sayles; Alison D Petro; Tuhina Neogi; James R O'Dell; Ted R Mikuls Journal: Arthritis Care Res (Hoboken) Date: 2022-03-16 Impact factor: 5.178
Authors: Abutaleb Ahsan Ejaz; Takahiko Nakagawa; Mehmet Kanbay; Masanari Kuwabara; Ada Kumar; Fernando E Garcia Arroyo; Carlos Roncal-Jimenez; Fumihiko Sasai; Duk-Hee Kang; Thomas Jensen; Ana Andres Hernando; Bernardo Rodriguez-Iturbe; Gabriela Garcia; Dean R Tolan; Laura G Sanchez-Lozada; Miguel A Lanaspa; Richard J Johnson Journal: Semin Nephrol Date: 2020-11 Impact factor: 5.299