The serum uric acid to creatinine ratio more accurately predicts death risk in patients receiving hemodialysis compared with either serum uric acid or serum creatinine alone, investigators reported in BMJ Nephrology.
Among 222 patients aged 60 years and older receiving hemodialysis, 78 died. Nonsurvivors were significantly older than survivors and had lower body mass index (BMI), serum creatinine, and prealbumin.
In adjusted analyses, increasing serum uric acid to creatinine ratio as a continuous variable was significantly associated with a 29% increased risk for all-cause mortality, Liubao Gu, MD, of Nanjing Medical University in China and colleagues reported. Other analyses showed that patients with the highest (0.95 or higher) vs lowest (less than 0.5) quartile of the serum uric acid to creatinine ratio had increased risk for all-cause mortality. The ratio also was strongly associated with cardiovascular mortality. A higher nutrition-normalized serum uric acid to creatinine ratio correlated with lower diastolic blood pressure, serum albumin, prealbumin, serum calcium, and serum phosphorus.
Net reclassification improvement results showed that the ratio was superior to serum uric acid or serum creatinine values alone. According to Dr Gu’s team, the ratio may reduce the interference of patient sex and renal function abnormalities.
Previous studies indicated that the serum uric acid to creatinine ratio could predict kidney disease development in patients with type 2 diabetes and kidney disease progression. The investigators in this study could not account for residual renal function, which is a limitation.
The authors said that, to their knowledge, the study is the first to examine the relationship between serum uric acid to creatinine ratio and all-cause mortality among elderly patients on hemodialysis.
Ding Z, Fan Y, Yao C, Gu L. The association between the serum uric acid to creatinine ratio and all-cause mortality in elderly hemodialysis patients. BMC Nephrol. Published online May 6, 2022. 23(1):177. doi:10.1186/s12882-022-02798-4