Serum Uric Acid and Mortality Risk Among Hemodialysis Patients.
body composition
hemodialysis
lean tissue index
mortality risk
nutrition
uric acid
Journal
Kidney international reports
ISSN: 2468-0249
Titre abrégé: Kidney Int Rep
Pays: United States
ID NLM: 101684752
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
05
12
2019
revised:
29
04
2020
accepted:
18
05
2020
entrez:
11
8
2020
pubmed:
11
8
2020
medline:
11
8
2020
Statut:
epublish
Résumé
Although high serum uric acid (SUA) has been consistently associated with an increased risk of death in the general population and in persons with nondialysis chronic kidney disease (CKD), studies in patients undergoing dialysis are conflicting. It has been postulated that low SUA simply reflects poor nutritional status in dialysis patients. We here characterize the association between SUA and the risk of death in a large dialysis cohort and explore effect modification by underlying nutritional status as reflected by body composition. In this retrospective cohort study, we included 16,057 hemodialysis (HD) patients treated during 2007 to 2016 in NephroCare centers as recorded in the European Clinical Database (EuCliD). The association between SUA, all-cause, and cardiovascular (CV)-related mortality was evaluated with competing risk models and characterized with splines. Effect modification was explored by lean tissue index (LTI) and fat tissue index (FTI). During a mean of 1.8 years of follow-up, 2791 patients (17.4%) died. We found a multivariable-adjusted U-shaped pattern between SUA and all-cause mortality. Patients with SUA levels of 6.5 mg/dl (387 μmol/l) were at the lowest risk of death (subdistribution hazard ratio = 0.94 [confidence interval {CI} 0.91; 0.96]). The form of association was not meaningfully affected by underlying LTI and FTI. We found a U-shaped pattern between SUA levels and all-cause mortality among HD patients, which was independent of the patients' body composition.
Identifiants
pubmed: 32775819
doi: 10.1016/j.ekir.2020.05.021
pii: S2468-0249(20)31282-1
pmc: PMC7403560
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1196-1206Informations de copyright
© 2020 International Society of Nephrology. Published by Elsevier Inc.
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