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Abstract: SA-PO1056

Effect of Serum Uric Acid Level on Mortality Risk in Maintenance Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Li, Ming, The Third Affiliated Hospital of Sun Yet-Sen University, Guangzhou, China
  • Li, Canming, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
  • Ye, Zengchun, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
  • Peng, Hui, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
  • Lou, Tan-qi, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Background

There is still much controversy about the relationship between serum uric acid level and all-cause or cardiovascular mortality in hemodialysis patients.

Methods

A retrospective cohort study was conducted to enroll 201 MHD patients in the Third Affiliated Hospital of Sun Yat-sen University. The baseline data of clinical and laboratory examinations were compared. The correlation between serum uric acid level and clinical variables was analyzed by Pearson correlation coefficient. Kaplan-Meier and Cox proportional hazard regression model was used to examine the association between serum uric acid and all-cause and cardiovascular mortality in HD patients.

Results

The average age of patients was 56.9 + 16.7 years, and the average baseline serum uric acid level was 531.1 + 137.9 umol/L. With 442 umol/L, 523 umol/L and 620 umol/L as the boundary points, the patients were divided into four groups according to the level of serum uric acid. The lowest quartile group was older and had more diabetes mellitus than the highest quartile group ( P< 0.05). Compared to the highest quartile group,the serum albumin, serum phosphorus and serum creatinine were lower in the lowest quartile group, while the hypersensitive C-reactive protein were higher(P < 0.05). Pearson correlation coefficient showed that uric acid level was positively correlated with albumin, serum phosphorus and serum creatinine. After a median follow-up of 49.8 months, 66 (32.8%) all-cause deaths and 37 (18.4%) cardiovascular deaths were recorded. Kaplan Meier method showed that with the decrease of serum uric acid, all-cause mortality (Log Rank = 23.63, P = 0.000)and cardiovascular mortality(Log Rank =23.10,P=0.000)increased. Cox proportional hazard model was used to correct age, sex, complications. It was found that for every 100 umol/L increase in baseline serum uric acid level, the risk of all-cause mortality decreased by 24.1% [HR 0.759 (0.595-0.968), P=0.026]. Compared to the highest group,all-cause mortality [HR 0.287 (0.118-0.696), P=0.006] and cardiovascular mortality [HR 0.147 (0.032-0.677), P=0.014] were higher in the lowest serum uric acid quartile group.

Conclusion

Low serum uric acid level increases the risk of all-cause mortality and cardiovascular mortality in MHD patients.

Funding

  • Government Support - Non-U.S.