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Kidney Week

Abstract: PO1270

Serum Uric Acid, Mortality, and Decline of Residual Kidney Function in Patients Undergoing Chronic Peritoneal Dialysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Coelho, Inês Dionisio, Hospital Amato Lusitano, Castelo Branco, Castelo Branco, Portugal
  • Rodriguez, Catuxa, Complexo Hospitalario Universitario A Coruna, A Coruna, Galicia, Spain
  • Rodriguez-carmona, Ana, Complexo Hospitalario Universitario A Coruna, A Coruna, Galicia, Spain
  • Perez Fontan, Miguel, Complexo Hospitalario Universitario A Coruna, A Coruna, Galicia, Spain
Background

Hyperuricemia is known to be associated with cardiovascular (CV) events and mortality in patients with chronic kidney disease (CKD). However, in the particular case of patients on chronic dialysis, the relationship between serum uric acid (UA) levels and adverse outcomes is less consistent. The aim of this study was to identify the correlation between UA, on one side, and all-cause mortality (primary endpoint) and the rate of decline of residual kidney function (RKF) (secondary endpoint), on the other, among patients undergoing chronic peritoneal dialysis (PD).

Methods

We conducted a single centre, retrospective, observational cohort study of 682 patients who started PD between 1990 and 2019. We recorded essential demographic, clinical and laboratory data at baseline, 6, 12 and 24 months. We categorized the study population according to the median of mean UA levels during the first 3 months on PD (hyperuricemic/nonhyperuricemic) and, on the other side, according to any of: mean UA above/below median and treatment with UA lowering agents (gouty/nongouty). Cox proportional hazard model was applied to investigate the primary endpoint, and logistic regression analysis was used to assess the secondary endpoint.

Results

The study population included 407 males and 275 females, with a mean age of 60.2±14.6 years. Diabetes was present in 30.9% (n=211) of the patients. Mean follow-up on PD was 31,4±25,6 months. In univariate analysis, hyperuricemic patients presented higher levels of albumin (p=0.001), phosphate (p=0.003) and haemoglobin (p=0.002), and lower levels of cholesterol (p<0.001) and ferritin (p=0.039). In multivariate analysis, hyperuricemia was not an independent predictor of the rate of decline of RKF (HR 1.069; 95% CI:0.695 -1.644; p=0.761) or mortality (HR 0.997; 95% CI:0.738 -1.345; p=0.983), after controlling for age, diabetes, comorbidity and baseline RKF. The same applied when the study population was categorized as gouty/nongouty patients.

Conclusion

Higher UA levels were not independent predictors of mortality or the rate of decline of RKF, in our patients on PD. Patients presenting higher UA levels display a better nutritional and inflammatory profile than those with lower UA levels, which may suggest a component of reverse epidemiology .