High Uric Acid Increases Risk of Non-Fatal Stroke in CKD Patients

Odds of non-fatal stroke are 49% higher in patients in the fourth quartile of uric acid level versus those in the second quartile.
Odds of non-fatal stroke are 49% higher in patients in the fourth quartile of uric acid level versus those in the second quartile.

High uric acid levels may increase the risk of non-fatal stroke in patients with chronic kidney disease (CKD), according to study findings presented at the European Renal Association-European Dialysis and Transplant Association 53rd Congress in Vienna.

Compared with patients in the second quartile of serum uric acid level (5.7–6.4 mg/dL in men and 4.5–5.1 mg/dL in women), those in the fourth quartile (7.4 mg/dL or higher in men and 6.0 mg/dL or higher in women) had a significant 49% increased odds of non-fatal stroke, Keita Kamei, MD, of the Yamagata University School of Medicine in Yamagata, Japan, and colleagues reported. These increased odds were preserved after adjusting for age, sex, comorbidities, and other confounders.

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For the study, the researchers used a national database of 22,333 individuals with an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2 who participated in an annual health checkup. Subjects' ages ranged from 39 to 73 years. During follow-up, 432 non-fatal strokes occurred. The lowest incidence rate was in the second quartile of uric acid (8.3 strokes per 1,000 person-years) and the highest rate was in the fourth quartile (12.3 per 1,000 person-years).

The increased odds of non-fatal stroke in the fourth quartile were significant in individuals without proteinuria, but not in those with proteinuria. Additionally, in subgroup analyses, individuals in the fourth quartile with dyslipidemia, diabetes, and eGFR less than 45 mL/min/1.73 m2 had greater odds of non-fatal stroke than subjects without these factors.

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