Kidney Res Clin Pract.  2017 Dec;36(4):368-376. 10.23876/j.krcp.2017.36.4.368.

Relationship between serum uric acid and mortality among hemodialysis patients: Retrospective analysis of Korean end-stage renal disease registry data

Affiliations
  • 1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. skimw@chonnam.ac.kr
  • 2Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 3Department of Rehabilitation, Presbyterian Medical Center, Jeonju, Korea.

Abstract

BACKGROUND
It is thought that hyperuricemia might lower the risk of mortality among hemodialysis patients, unlike in the general population, but the evidence is controversial. The aim of the current study was to evaluate the impact of serum uric acid level on the long-term clinical outcomes of hemodialysis patients in Korea.
METHODS
Retrospective analysis was performed on data from the End-Stage Renal Disease Registry of the Korean Society of Nephrology. This included data for 7,333 patients (mean age, 61 ± 14 years; 61% male) who received hemodialysis from January 2001 through April 2015. Initial laboratory data were used in the analysis.
RESULTS
The mean serum uric acid level in this study was 7.1 ± 1.7 mg/dL. Body mass index, normalized protein catabolic rate, albumin, and cholesterol were positively correlated with serum uric acid level after controlling for age and sex. After controlling for demographic data, comorbidities, and residual renal function, a higher uric acid level was independently associated with a significantly lower all-cause mortality (hazard ratio [HR], 0.90 per 1 mg/dL increase in uric acid level; 95% confidence interval [CI], 0.83-0.97; P = 0.008), but not cardiovascular mortality (HR, 0.90; 95% CI, 0.80-1.01; P = 0.078). Comparing uric acid levels in the highest and lowest quintiles, the HR for all-cause mortality was 0.65 (95% CI, 0.42-0.99; P = 0.046).
CONCLUSION
Hyperuricemia was strongly associated with a lower risk of all-cause mortality, but there seems to be no significant association between serum uric acid level and cardiovascular mortality among Korean hemodialysis patients with end-stage renal disease.

Keyword

Renal dialysis; Hyperuricemia; Mortality; Korea

MeSH Terms

Body Mass Index
Cholesterol
Comorbidity
Humans
Hyperuricemia
Kidney Failure, Chronic*
Korea
Mortality*
Nephrology
Renal Dialysis*
Retrospective Studies*
Uric Acid*
Cholesterol
Uric Acid
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