Abstract: FR-PO436
Sex-Specific Association Between Serum Uric Acid and Cause-Specific Mortality in Maintenance Hemodialysis Patients: A Multicenter Prospective Cohort Study
Session Information
- Hemodialysis and Frequent Dialysis - III
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Yang, Yaya, Nanfang Hospital, Guangzhou, China
- Liang, Min, Nanfang Hospital, Guangzhou, China
Background
Studies have shown inconsistent results about the association between serum uric acid (SUA) and mortality in maintenance hemodialysis (MHD) patients. Moreover, no studies have explored the possibilities of the relationship between SUA and non-cardiovascular (CVD) mortality.
Methods
We conducted a multicenter prospective cohort study among 1039 MHD patients. The blood samples of all participants were obtained prior to the hemodialysis session at baseline. Multivariable adjusted Cox proportional hazards models were used to estimate the HRs and 95%CIs for the risk of all-cause mortality, CVD mortality and non-CVD mortality associated with SUA.
Results
Over a median follow-up of 28 months, 230 deaths were recorded, of which 140 (60.9) were due to cardiovascular disease. overall, a U-shaped relationship was found between SUA and all-cause mortality. Moreover, the patients in the lowest SUA showed a higher risk of CVD mortality (HR: 1.57, 95%CI: 1.03-2.40), whereas no significant association was found with non-CVD mortality. By contrast, the patients in the highest SUA group showed a higher risk of non-CVD mortality (HR:1.82, 95%CI: 1.04-3.17) and no significant association was found with CVD mortality. The association between SUA and all-cause mortality were consistent across different subgroups.
Conclusion
There was a U-shaped relationship between SUA and all-cause mortality. Furthermore, lower SUA had an increased risk of CVD mortality and higher SUA had a higher risk of non-CVD mortality. Whether SUA reduction therapy is beneficial to the MHD patients should be the subject of the future research work.
The association between sex-specific serum uric acid levels and mortality
SUA, mg/dl | No. events(%) | Adjusted HR(95%CI) | P |
All-cause mortality | |||
Tertile 1 | 100 (28.9%) | 1.45 (1.04, 2.03) | 0.029 |
Tertile 2 | 61 (17.6%) | 1.0(Ref) | -- |
Tertile 3 | 69 (19.9%) | 1.46 (1.02, 2.11) | 0.040 |
CVD mortality | |||
Tertile 1 | 68 (19.7%) | 1.57 (1.03, 2.40) | 0.035 |
Tertile 2 | 37 (10.7%) | 1.0(Ref) | -- |
Tertile 3 | 35 ( 10.1%) | 1.24 (0.76, 2.01) | 0.384 |
Non-CVD mortality | |||
Tertile 1 | 32 ( 9.2%) | 1.22 (0.71, 2.13) | 0.476 |
Tertile 2 | 24 ( 6.9%) | 1.0(Ref) | -- |
Tertile 3 | 34 ( 9.8%) | 1.82 (1.04, 3.17) | 0.036 |