Tags

Type your tag names separated by a space and hit enter

J-shaped mortality relationship for uric acid in CKD.
Am J Kidney Dis 2006; 48(5):761-71AJ

Abstract

BACKGROUND

Hyperuricemia is a common feature in patients with chronic kidney disease (CKD). Hyperuricemia has been associated with increased cardiovascular mortality in the general population, but less is known about this association in patients with CKD.

METHODS

To explore possible associations of serum uric acid with all-cause mortality and comorbidity in patients with CKD, we studied 294 incident patients with CKD stage 5 (185 men; age, 53 +/- 12 years) starting renal replacement therapy with a median glomerular filtration rate of 6.4 mL/min/1.73 m(2) (0.11 mL/s/1.73 m(2); range, 0.8 to 14.3 mL/min/1.73 m(2) [0.01 to 0.24 mL/s/1.73 m(2)]). Survival was determined from the day of examination and during a mean follow-up period of 27 months (range, 3 to 72 months); 94 patients died. Patients were divided into 3 groups based on serum uric acid levels (low quintile, 3 middle quintiles, and high quintile).

RESULTS

In a nonadjusted analysis, patients in the high quintile, followed by patients in the low quintile, had greater all-cause mortality compared with patients in the 3 middle quintiles (log-rank test chi-square, 6.8; P = 0.03). After adjusting for age, sex, glomerular filtration rate, cholesterol level, phosphate level, C-reactive protein level, cardiovascular disease, diabetes mellitus, diuretics, and allopurinol treatment, the association showed a "J-shaped" association with hazard ratios of 1.96 (confidence interval, 1.10 to 3.48; P = 0.02) for the high quintile and 1.42 (confidence interval, 0.76 to 2.66; P = not significant) for the low quintile. Moreover, uric acid levels correlated positively with levels of triglycerides, phosphate, C-reactive protein, and intracellular adhesion molecule 1 and negatively with levels of calcium, high-density lipoprotein cholesterol, and apolipoprotein A.

CONCLUSION

Serum uric acid levels showed a J-shaped association with all-cause mortality, with the lowest risk in the 3 middle quintiles. Moreover, uric acid level was associated with calcium/phosphate metabolism, dyslipidemia, and inflammation.

Authors+Show Affiliations

Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17059995

Citation

Suliman, Mohamed E., et al. "J-shaped Mortality Relationship for Uric Acid in CKD." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 48, no. 5, 2006, pp. 761-71.
Suliman ME, Johnson RJ, García-López E, et al. J-shaped mortality relationship for uric acid in CKD. Am J Kidney Dis. 2006;48(5):761-71.
Suliman, M. E., Johnson, R. J., García-López, E., Qureshi, A. R., Molinaei, H., Carrero, J. J., ... Stenvinkel, P. (2006). J-shaped mortality relationship for uric acid in CKD. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 48(5), pp. 761-71.
Suliman ME, et al. J-shaped Mortality Relationship for Uric Acid in CKD. Am J Kidney Dis. 2006;48(5):761-71. PubMed PMID: 17059995.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - J-shaped mortality relationship for uric acid in CKD. AU - Suliman,Mohamed E, AU - Johnson,Richard J, AU - García-López,Elvia, AU - Qureshi,A Rashid, AU - Molinaei,Hadi, AU - Carrero,Juan Jesús, AU - Heimbürger,Olof, AU - Bárány,Peter, AU - Axelsson,Jonas, AU - Lindholm,Bengt, AU - Stenvinkel,Peter, PY - 2006/05/24/received PY - 2006/08/15/accepted PY - 2006/10/25/pubmed PY - 2006/12/9/medline PY - 2006/10/25/entrez SP - 761 EP - 71 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 48 IS - 5 N2 - BACKGROUND: Hyperuricemia is a common feature in patients with chronic kidney disease (CKD). Hyperuricemia has been associated with increased cardiovascular mortality in the general population, but less is known about this association in patients with CKD. METHODS: To explore possible associations of serum uric acid with all-cause mortality and comorbidity in patients with CKD, we studied 294 incident patients with CKD stage 5 (185 men; age, 53 +/- 12 years) starting renal replacement therapy with a median glomerular filtration rate of 6.4 mL/min/1.73 m(2) (0.11 mL/s/1.73 m(2); range, 0.8 to 14.3 mL/min/1.73 m(2) [0.01 to 0.24 mL/s/1.73 m(2)]). Survival was determined from the day of examination and during a mean follow-up period of 27 months (range, 3 to 72 months); 94 patients died. Patients were divided into 3 groups based on serum uric acid levels (low quintile, 3 middle quintiles, and high quintile). RESULTS: In a nonadjusted analysis, patients in the high quintile, followed by patients in the low quintile, had greater all-cause mortality compared with patients in the 3 middle quintiles (log-rank test chi-square, 6.8; P = 0.03). After adjusting for age, sex, glomerular filtration rate, cholesterol level, phosphate level, C-reactive protein level, cardiovascular disease, diabetes mellitus, diuretics, and allopurinol treatment, the association showed a "J-shaped" association with hazard ratios of 1.96 (confidence interval, 1.10 to 3.48; P = 0.02) for the high quintile and 1.42 (confidence interval, 0.76 to 2.66; P = not significant) for the low quintile. Moreover, uric acid levels correlated positively with levels of triglycerides, phosphate, C-reactive protein, and intracellular adhesion molecule 1 and negatively with levels of calcium, high-density lipoprotein cholesterol, and apolipoprotein A. CONCLUSION: Serum uric acid levels showed a J-shaped association with all-cause mortality, with the lowest risk in the 3 middle quintiles. Moreover, uric acid level was associated with calcium/phosphate metabolism, dyslipidemia, and inflammation. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/17059995/J_shaped_mortality_relationship_for_uric_acid_in_CKD_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(06)01356-4 DB - PRIME DP - Unbound Medicine ER -