Hyperuricemia is a risk factor for cardiovascular and all-cause mortality and it increases in parallel with reduction in kidney function, according to study findings presented at the 2021 congress of the European Renal Association-European Dialysis and Transplant Association.

The findings are from a retrospective study of 21,963 patients who participated in the Uric Acid Right Heart Health (URRAH) project. A total of 1582 cardiovascular events and 3130 deaths occurred during 9.8 years of follow-up.

Each 1 mg/dL increase in uric acid level was significantly associated with a 21% and 10% increased risk for cardiovascular mortality and all-cause mortality in adjusted analyses, respectively, investigator Elisa Russo, MD, of the University of Genoa, IRCCS Policlinico San Martino, Genoa, Italy, reported in an oral presentation. In addition, compared with patients who had an estimated glomerular filtration rate (eGFR) above 90 mL/min/1.73 m2, those with an eGFR of 60-90 and less than 60 mL/min/1.73 m2 had a 30% and 33% increased risk for cardiovascular mortality, respectively.

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Cardiovascular mortality was significantly more likely among patients with both hyperuricemia and albuminuria compared with those who had neither risk factor. During 215,618 person-years of follow-up, the incidence rate for cardiovascular mortality among patients with hyperuricemia and albuminuria was 3.8, 22.1, and 19.1 per 1000 person-years for those with an eGFR higher than 90, 60-90, and less than 60 mL/min/1.73 m2, respectively, compared with 0.4, 2.8, and 3.1 per 1000 person-years, respectively, for patients with none of those risk factors.

The investigators concluded that baseline serum uric acid values and the presence of chronic kidney disease and each of its components are potent predictors of future cardiovascular and all-cause mortality.


Viazzi F, Russo E, Leoncini G, Pontremoli R, Borghi C, on behalf of the Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension (SIIA). Serum uric and kidney disease measure independently predict cardiovascular and total mortality: The Uric Acid Right Heart Health (URRAH) Project. Presented at: ERA-EDTA 59th congress, June 5-8, 2021. Abstract FC002.