Kidney Week

Abstract: FR-PO864

Pre-ESRD Uric Acid Levels and 1-Year Post-ESRD Hospital Admissions: A Transition of Care in CKD Study

Session Information

• Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular - II
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

• 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

• Park, Christina, UC Irvine, Orange, California, United States

Christina Park,

• Soohoo, Melissa, UC Irvine, Orange, California, United States

Melissa Soohoo,

• Streja, Elani, UC Irvine, Orange, California, United States

Elani Streja,

• Obi, Yoshitsugu, UC Irvine, Orange, California, United States

Yoshitsugu Obi,

• Moradi, Hamid, UC Irvine, Orange, California, United States

Hamid Moradi,

• Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

• Kalantar-Zadeh, Kamyar, UC Irvine, Orange, California, United States

Kamyar Kalantar-Zadeh,

Background

Elevated serum uric acid (SUA) levels are associated with higher risk of mortality in patients with chronic kidney disease, yet are paradoxically associated with lower risk of mortality in hemodialysis patients. Though the relationship of SUA and mortality has been studied, the relationship of pre-ESRD (end-stage renal disease) SUA levels and early post-ESRD hospitalization rates is relatively unknown.

Methods

Among US veterans who transitioned to ESRD in 2007-2014, we identified 10,715 patients with SUA measurements within 6 months prior to the start of dialysis treatment (prelude). Using Poisson regression, we calculated incidence rate ratios (IRR) for hospitalizations during the first year after initiation according to prelude SUA strata, hierarchically adjusting for case-mix and laboratory covariates.

Results

Patients were 67 ± 11 years old, 2% female, 34% African-American and 69% diabetic. The 6-month prelude SUA was 8.1 ± 2.2 mg/dL. The median [IQR] number of hospital admissions during the first year on dialysis was 1 [0-3] with an incidence rate of 2 per 100 patient-years. A U-shaped association was observed between SUA and 1-year post-ESRD hospitalizations. In the fully adjusted model, compared with the reference group (7-<8 mg/dL), the IRR were higher among the low and high (IRR [95%CI]: 1.06 [1.00, 1.11] and 1.10 [1.05, 1.14], respectively), but not intermediate 6-month pre-ESRD SUA strata, for hospitalization within the first year of dialysis [Figure]

Conclusion

High and low prelude SUA levels were associated with a higher rate of hospitalization following the first year of dialysis initiation. Further investigation is needed to examine the mechanism behind pre-ESRD SUA levels and post-ESRD hospitalizations in this population.

Funding

• NIDDK Support