Older adults with high levels of serum uric acid prior to onset of end-stage kidney disease (ESKD) have increased risks for death once they transition to dialysis, according to new research presented at the American Society of Nephrology’s Kidney Week 2020 Reimagined virtual meeting. Younger adults with hyperuricemia, however, do not appear to have this excess mortality risk.

Investigators stratified 9110 veterans (2% female; 36% African American) by age and mean uric acid level in the 3 months leading to dialysis initiation. Mean prelude uric acid level was 8.13 mg/dL for the cohort. During a median 25 months, 4521 patients died.

Veterans aged 65 years and older who had the highest prelude uric acid of 10 mg/dL or higher had a significant 18% increased risk for all-cause mortality compared with veterans with a uric acid level of 7 to less than 8 mg/dL, Nicholas Cuvelier, MS, MPh, of Harold Simmons Center for Kidney Disease Research and Epidemiology at the University of California Irvine in Orange, California, and colleagues reported. Patients younger than 65 years with a uric acid of 10 mg/dL and higher had no excess death risk. The Cox proportional hazards regression model was adjusted for age, gender, race, comorbidities, and various lab measurements.

Among older patients, pre-ESKD uric acid can be informative of post-ESKD outcomes, according to Cuvelier’s team. “Further study is warranted to examine the relationship between age and uric acid with outcomes among kidney disease patients.”

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Cuvelier N, Wenziger C, Hsiung JT, et al. Impact of age on the association of pre-ESRD uric acid with post-transition mortality among US veterans. Presented at: Kidney Week 2020 Reimagined, October 19-25, 2020. Poster PO1039.