Effects of serum uric acid level on all?cause death and cardiovascular death in patients of maintaining peritoneal dialysis
10.3760/cma.j.issn.1001?7097.2018.11.002
- VernacularTitle:维持性腹膜透析患者血清尿酸水平对全因死亡及心血管事件死亡的影响
- Author:
Qilong ZHANG
1
,
2
;
Junni WANG
;
Yaomin WANG
;
Xishao XIE
;
Shilong XIANG
;
Xiaohui ZHANG
;
Jianghua CHEN
;
Fei HAN
Author Information
1. 310003杭州,浙江大学医学院附属第一医院肾脏病中心 浙江大学肾脏病研究所 浙江省肾脏病防治技术研究重点实验室
2. 浙江省安吉县人民医院肾内科
- Keywords:
Peritoneal dialysis;
Uric acid;
Prognosis;
All?cause mortality;
Cardiovascular diseases
- From:
Chinese Journal of Nephrology
2018;34(11):809-815
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of serum uric acid (SUA) on all?cause death and cardiovascular death in patients of maintaining peritoneal dialysis (PD). Methods One thousand and sixty?three PD patients in the First Affiliated Hospital of Zhejiang University Medical College were included. The SUA levels at 6 months after PD start were measured. Patients with SUA≥420 μmol/L were grouped in hyperuricemia group (492 cases) and patients with SUA<420 μmol/L were grouped in normal uric acid group (571 cases). The effects on all ? cause mortality and cardiovascular mortality were retrospectively analyzed. Results The median age of the patients was 51(41, 62) years; 557 cases were male (52.40％); the median follow?up time was 33(20, 54) months (6?96 months); 167 cases (15.71％) died during the follow?up period, including 64 cases (6.02％) withcardiovascular causes. The mortality in hyperuricemia group was 19.11％(94/492) and the cardiovascular mortality was 7.93％(39/492), both rates were higher than those in normal uric acid group, and the differences were statistically significant (P=0.005, P=0.015, respectively). Hyperuricemia (SUA≥420μmol/L) at 6 months after PD start (HR=1.572, 95％CI 1.155-2.141, P=0.004), high uric acid level (continuous variable) at 6 months after PD start (HR=1.002, 95％CI 1.001-1.004, P=0.008), and age≥65 years (HR=3.571, 95％CI 2.556-4.990, P<0.001), serum albumin≤30 g/L (HR=1.907, 95％CI 1.278-2.845, P=0.002), high Charlson comorbidity index (HR=1.209, 95％CI 1.032-1.417, P=0.019) at the beginning of PD start were independent risk factors for all ? causes death in PD patients. Hyperuricemia (SUA≥420 μmol/L) at 6 months after PD start (HR=1.734, 95％CI 1.033-2.912, P=0.037) and age≥65 years (HR=1.761, 95％CI 1.024-3.209, P=0.041), with diabetes (HR=2.775, 95％CI 1.358-5.671, P=0.005) at the beginning of PD start were independent risk factors for cardiovascular death in PD patients. Conclusions SUA at 6 months after PD is an independent risk factor for all?cause death and cardiovascular death in PD patients.
