High serum uric acid is an independent risk factor for death in patients on peritoneal dialysis (PD), according to investigators.
Compared with serum uric levels in the third quintile (reference), levels in the fourth and fifth quintiles were significantly associated with a 1.3-fold and nearly 1.5-fold increased risk of all-cause mortality, respectively, in a fully adjusted model, a team led by Jianghua Chen, MD, of the Zhejiang University in Hangzhou, China, reported in Nutrition & Metabolism. The association between high uric acid and all-cause mortality was more pronounced in men than women, patients with relatively lower serum albumin levels and body mass index, and patients without diabetes mellitus. The investigators found no significant association between uric acid levels and cardiovascular mortality.
“Our results provide evidence regarding the treatment of hyperuricemia in the PD population,” the authors concluded.
The observational study included 9405 PD patients from the Zhejiang Renal Data system. Patients had a mean age of 52 years and a mean serum uric acid level of 7.07 mg/dL at baseline. During a follow-up of 29.4 months, 1226 patients (13%) died. Of these, 515 (5.5%) died from cardiovascular causes.
The first, second, third, fourth, and fifth quintiles of serum uric acid were as follows: less than 6.06, 6.06 to 6.67, 6.68 to 7.27, 7.28 to 8.03, and 8.04 mg/dL or higher, respectively. Patients in the third quintile had the highest overall and cardiovascular survival rates.
In a previous study, which was published in Kidney & Blood Pressure Research in 2013, investigators found that PD patients in the highest quartile of serum uric acid had a nearly 3-fold increased risk of all-cause mortality compared with those in the second and third quartiles.
Xiang S, Zhang X, Xie X, et al. High serum uric acid is a mortality risk factor in peritoneal dialysis patients: a retrospective cohort study. Nutr Metab. 2019.