Kidney Week

Abstract: TH-PO479

Impact of Renal Function on Association between Uric Acid and All-Cause Mortality in Patients with Chronic Heart Failure

Session Information

• CKD: Epidemiology, Outcomes - Cardiovascular - I
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Chronic Kidney Disease (Non-Dialysis)

• 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

• Stubnva, Viera, Finnmark Hospital Trust, Kirkenes, Norway

Viera Stubnva,

• Os, Ingrid, Oslo University Hospital, Oslo, Norway

Ingrid Os,

• Grundtvig, Morten, Innlandet Hospital Trust Lillehammer, Lillehammer, Norway

Morten Grundtvig,

• Waldum-Grevbo, Bård, Oslo University Hospital, Ullevål and University of Oslo, Oslo, Norway

Bård Waldum-Grevbo,

Background

Serum uric acid (SUA) is associated with poor prognosis in patients with heart failure (HF). It is still unclear whether there is a causal inference between SUA and increased mortality. We investigated if SUA was an independent predictor of all-cause mortality in HF outpatients using a propensity score matching model to correct for possible confounding variables. As SUA is closely related to renal function, we examined if renal function affected the relationship between SUA and all-cause mortality.

Methods

Patients from the Norwegian Heart Failure Registry with available baseline SUA were eligible for the study. Individuals in the highest SUA quartile were propensity score matched 1:1 with patients in the three lowest quartiles. The propensity score matching procedure was based on 16 measured baseline characteristics. Univariate Cox regression analyses were used to investigate the independent effect of SUA on all-cause mortality.

Results

A total of 4698 patients (70.4%) had valid registrations of SUA and were included in the study. Propensity score matching identified 886 pairs of patients (SUA quartile 4 compared to SUA quartiles 1 to 3). The groups were well matched, mean age was 71.1± 11.6 years, 74% were males, and mean eGFR was 50.0±20.8 ml/min/1.73 m². SUA was an independent predictor of all-cause mortality in HF outpatients (hazard ratio (HR) 1.21, 95% confidence interval (CI) 1.05-1.39). Renal function was found to interact the relationship between SUA and all-cause mortality (p=0.011). In patients with normal renal function (eGFR > 60 ml/min/1.73 m²), SUA remained an independent predictor for all-cause mortality (HR1.67, 95% CI 1.25-2.24). In contrast, high SUA levels did not predict outcome in HF outpatients with renal dysfunction (HR 1.09, 95% CI 0.93-1.28).

Conclusion

Elevated SUA was an independent predictor of all-cause mortality in HF outpatients in this propensity matched study. However, SUA was associated with poor outcome only in patients with normal renal function, but not in patients with renal dysfunction.