The Associations of Uric Acid, Cardiovascular and All-Cause Mortality in Peritoneal Dialysis Patients

PLoS One

Jiang-Hua Chen¹  Qing-Feng Han²  Mei Wang²  Ye-Ping Ren³  Hai-Yan Wang³  Tong-Ying Zhu⁴  Na Tian⁴  Rui Zhang⁵  Meng-Hua Chen⁶  Chuan-Ming Hao⁷  Hui-Ping Zhao⁸  Rong Xu⁹  Yue Wang^1,10  Xiao-Hui Zhang^1,11  Jie Dong^1,11 

[1] Beijing, China;Institute of Nephrology, Peking University;Key Laboratory of Renal Disease, Ministry of Education;Key Laboratory of Renal Disease, Ministry of Health;Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China;Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China;Department of Nephrology, Peking University People's Hospital, Beijing, China;Department of Nephrology, Peking University Third Hospital, Beijing, China;Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China;Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China;Renal Division, Department of Medicine, Peking University First Hospital

关键词: Cardiovascular diseases;    Diabetes mellitus;    Chronic kidney disease;    Medical dialysis;    Blood pressure;    Renal system;    Serum albumin;    Uric acid;   

DOI  :  10.1371/journal.pone.0082342

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Aims To investigate whether uric acid (UA) is an independent predictor of cardiovascular (CV) and all-cause mortality in peritoneal dialysis (PD) patients after controlling for recognized CV risk factors.Methods A total of 2264 patients on chronic PD were collected from seven centers affiliated with the Socioeconomic Status on the Outcome of Peritoneal Dialysis (SSOP) Study. All demographic and laboratory data were recorded at baseline. Multivariate Cox regression was used to calculate the hazard ratio (HR) of CV and all-cause mortality with adjustments for recognized traditional and uremia-related CV factors.Results There were no significant differences in baseline characteristics between patients with (n = 2193) and without (n = 71) UA measured. Each 1 mg/dL of increase in UA was associated with higher all-cause mortality with 1.05(1.00∼1.10) of HR and higher CV mortality with 1.12 (1.05∼1.20) of HR after adjusting for age, gender and center size. The highest gender-specific tertile of UA predicted higher all-cause mortality with 1.23(1.00∼1.52) of HR and higher CV mortality with 1.69 (1.21∼2.38) of HR after adjusting for age, gender and center size. The predictive value of UA was stronger in patients younger than 65 years without CV disease or diabetes at baseline. The prognostic value of UA as both continuous and categorical variable weakened or disappeared after further adjusted for uremia-related and traditional CV risk factors.Conclusions The prognostic value of UA in CV and all-cause mortality was weak in PD patients generally, which was confounded by uremia-related and traditional CV risk factors.

【 授权许可】

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