Serum uric acid levels and health outcomes in CKD : a prospective cohort study
© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA..
BACKGROUND: Hyperuricemia is prevalent in individuals with chronic kidney disease (CKD). Elevated serum uric acid (SUA) concentrations have been considered an independent risk factor for the onset of CKD. However, the relationship between SUA concentrations and long-term health outcomes among patients with CKD remains unclear.
METHODS: We performed a prospective cohort study with nationally representative sample to investigate the relationship between SUA concentrations and mortality risk including all-cause, cardiovascular disease (CVD) and cancer mortality, among patients with CKD. The weighted restricted cubic spline analyses combined with the multivariate-adjusted Cox proportional hazard models were used to test the nonlinearity of relationship.
RESULTS: The 6642 patients participating in National Health and Nutrition Examination Survey 1999-2018 were enrolled. During 656 885 person-months of follow-up time, 2619 all-cause deaths were recorded, including 1030 CVD deaths and 458 cancer deaths. Our study presented J-shaped non-linear relationships between SUA concentrations and all-cause and CVD mortality with inflection points at 311.65 μmol/L and 392.34 μmol/L, respectively. When SUA concentration was higher than those inflection points, every increase of 50 μmol/L SUA was associated with 11.7% and 17.0% greater multivariable-adjusted hazard ratio of all-cause and CVD mortality, respectively. In addition, a negative linear correlation with cancer mortality was detected.
CONCLUSION: These findings suggested that maintaining appropriate SUA concentrations may improve long-term health outcomes among CKD patients. The corresponding inflection points of J-shaped non-linear relationships were 311.65 and 392.34 μmol/L for all-cause and CVD mortality. Further clinical trials are required to investigate uric acid-lowering targets.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:39 |
|---|---|
| Enthalten in: |
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association - 39(2024), 3 vom: 28. Feb., Seite 510-519 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Wu, Shijie [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
268B43MJ25 |
|---|
| Anmerkungen: |
Date Completed 29.02.2024 Date Revised 29.02.2024 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1093/ndt/gfad201 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM361962592 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM361962592 | ||
| 003 | DE-627 | ||
| 005 | 20240229234320.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/ndt/gfad201 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1311.xml |
| 035 | |a (DE-627)NLM361962592 | ||
| 035 | |a (NLM)37698875 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Wu, Shijie |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Serum uric acid levels and health outcomes in CKD |b a prospective cohort study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 29.02.2024 | ||
| 500 | |a Date Revised 29.02.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. | ||
| 520 | |a BACKGROUND: Hyperuricemia is prevalent in individuals with chronic kidney disease (CKD). Elevated serum uric acid (SUA) concentrations have been considered an independent risk factor for the onset of CKD. However, the relationship between SUA concentrations and long-term health outcomes among patients with CKD remains unclear | ||
| 520 | |a METHODS: We performed a prospective cohort study with nationally representative sample to investigate the relationship between SUA concentrations and mortality risk including all-cause, cardiovascular disease (CVD) and cancer mortality, among patients with CKD. The weighted restricted cubic spline analyses combined with the multivariate-adjusted Cox proportional hazard models were used to test the nonlinearity of relationship | ||
| 520 | |a RESULTS: The 6642 patients participating in National Health and Nutrition Examination Survey 1999-2018 were enrolled. During 656 885 person-months of follow-up time, 2619 all-cause deaths were recorded, including 1030 CVD deaths and 458 cancer deaths. Our study presented J-shaped non-linear relationships between SUA concentrations and all-cause and CVD mortality with inflection points at 311.65 μmol/L and 392.34 μmol/L, respectively. When SUA concentration was higher than those inflection points, every increase of 50 μmol/L SUA was associated with 11.7% and 17.0% greater multivariable-adjusted hazard ratio of all-cause and CVD mortality, respectively. In addition, a negative linear correlation with cancer mortality was detected | ||
| 520 | |a CONCLUSION: These findings suggested that maintaining appropriate SUA concentrations may improve long-term health outcomes among CKD patients. The corresponding inflection points of J-shaped non-linear relationships were 311.65 and 392.34 μmol/L for all-cause and CVD mortality. Further clinical trials are required to investigate uric acid-lowering targets | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a chronic kidney disease | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a uric acid | |
| 650 | 7 | |a Uric Acid |2 NLM | |
| 650 | 7 | |a 268B43MJ25 |2 NLM | |
| 700 | 1 | |a Xue, Wen |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Hanqing |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Hanjie |e verfasserin |4 aut | |
| 700 | 1 | |a Shi, Zhaoqiang |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Ling |e verfasserin |4 aut | |
| 700 | 1 | |a Peng, Ai |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association |d 1990 |g 39(2024), 3 vom: 28. Feb., Seite 510-519 |w (DE-627)NLM012639206 |x 1460-2385 |7 nnns |
| 773 | 1 | 8 | |g volume:39 |g year:2024 |g number:3 |g day:28 |g month:02 |g pages:510-519 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/ndt/gfad201 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 39 |j 2024 |e 3 |b 28 |c 02 |h 510-519 | ||