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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

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/dlNo. events(%)Adjusted HR(95%CI)P
All-cause mortality   
Tertile 1100 (28.9%)1.45 (1.04, 2.03)0.029
Tertile 261 (17.6%)1.0(Ref)--
Tertile 369 (19.9%)1.46 (1.02, 2.11)

0.040
CVD mortality   
Tertile 168 (19.7%)1.57 (1.03, 2.40) 0.035
Tertile 237 (10.7%)1.0(Ref)--
Tertile 335 ( 10.1%)1.24 (0.76, 2.01)0.384
Non-CVD mortality   
Tertile 132 ( 9.2%)1.22 (0.71, 2.13) 0.476
Tertile 224 ( 6.9%)1.0(Ref)--
Tertile 334 ( 9.8%)1.82 (1.04, 3.17) 0.036