Abstract: TH-PO0297
Novel Algorithm to Adjust Uric Acid for the Glomerular Filtration Rate: Improved Prediction of All-Cause and Cardiovascular Mortality in the LURIC Study
Session Information
- Hypertension and CVD: Clinical - 1
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Koenigshausen, Eva, Heinrich-Heine-Universitat Dusseldorf, Düsseldorf, NRW, Germany
- Rubel, Johanna, Heinrich-Heine-Universitat Dusseldorf, Düsseldorf, NRW, Germany
- März, Winfried, Universitat Heidelberg Medizinische Fakultat Heidelberg, Heidelberg, BW, Germany
- Rump, Lars C., Heinrich-Heine-Universitat Dusseldorf, Düsseldorf, NRW, Germany
- Sellin, Lorenz, Heinrich-Heine-Universitat Dusseldorf, Düsseldorf, NRW, Germany
Background
Elevated uric acid (UA) and the UA to serum creatinine ratio (sUA/sCr) are associated with increased cardiovascular risk. We examined whether UA adjusted for glomerular filtration (eGFR), age, and sex (eUA) further enhances cardiovascular risk prediction.
Methods
The study was carried out in the LURIC cohort. We excluded persons with eGFR < 10 or > 100 ml/min/1.73 m2 which left 2182 persons for analysis. Receiver operating characteristic (ROC) curves were calculated to predict all-cause and cardiovascular mortality for the parameters eUA, sUA/sCr and UA. eUA levels were calculated with a new formula in men and women, respectively. All-cause and cardiovascular mortality were analyzed in three groups (UA < eUA, UA = eUA and UA > eUA). Uni- and multivariate Cox regression analysis were performed for known risk factors and UA, eUA and sUA/sCr. Survival over a mean follow-up of 12.62 ± 6 years (8.64 ± 3.12 years for cardiovascular mortality) was analyzed using Cox-models and Kaplan-Meier analysis.
Results
The area under the ROC curves for predicting all-cause and cardiovascular mortality were significantly higher for eUA in both men and women compared to UA and sUA/sCr. Multivariate analysis revealed a better prediction of all-cause with eUA (HR 1.35; 95 % CI 1.37 - 1.70) compared to UA (HR 1.15; 95 % CI 1.11 - 1.19) and sUA/sCr (HR 1.08; 95 % CI 1.05 - 1.12) and cardiovascular mortality (eUA HR 1.53; 95 % CI 1.37 - 1.70), UA (HR 1.16; 95 % CI 1.09 - 1.23), and sUA/sCr (HR1.07; 95% CI 1.01 - 1.13) after adjustment for known cardiovascular risk factors. Persons with UA > eUA show a significantly decreased survival compared to persons with UA < eUA.
Conclusion
The new parameter eUA identifies persons at particularly increased cardiovascular risk and predicts mortality significantly better than the established markers UA or sUA/sCr. If UA levels exceed eUA, the risk for all-cause mortality and cardiovascular death is highest. This will help to guide monitoring and pharmacological treatment in these patients.