Low, High Uric Acid Ups Post-ESRD Death Risk
Levels of 10 mg/dL or higher and below 6 mg/dL predicted approximately 50% higher death risk in the 3 months after dialysis initiation.
CHICAGO—Both low and very high serum uric acid levels in patients with chronic kidney disease (CKD) predict an elevated risk of death after progressing to end-stage renal disease (ESRD), according to study findings presented at the American Society of Nephrology's Kidney Week 2016 meeting.
Vanessa A. Ravel, MD, of the University of California Irvine, and colleagues identified 6086 US veterans with a pre-dialysis uric acid measurement in the 6 months prior to starting dialysis. Patients had a mean age of 67 years, and diabetes and hypertensions were the predominant cause of ESRD.
In adjusted analyses, patients with 6-month averaged uric acid levels of 10 mg/dL or higher and below 6 mg/dL had an approximately 50% increased risk of all-cause mortality during the first 3 months on dialysis compared with patients who had uric acid levels of at least 6 but less than 8 mg/dL (reference), Dr Ravel's team reported. “Whether this U-shaped association calls for changes to therapeutic paradigms regarding pre-ESRD hypo- and hyperuricemia warrants further studies,” the investigators concluded in a poster presentation.
Overall, 9.3% of patients died during the first 3 months after transitioning to dialysis. Prior to development of end-stage renal disease, the cohort had a 6-month average uric acid level of 8.07 mg/dL.
- Ravel VA et al. Association of pre-ESRD uric acid with post-ESRD mortality: A transition of care in CKD study. Poster presented at Kidney Week 2016 in Chicago, Nov. 15-20. Poster TH-PO649.