Association between serum uric acid and all-cause and cardiovascular-related mortality in hemodialysis patients

作者：Wenyuan Gan, Fan Zhu, Xun Fang, Wenzhe Wang, Danni Shao, Huihui Mao, Xiao Wei, Wenli Chen, Fang Xu, Xingruo Zeng · 发表于：Frontiers in Nutrition · 年份：2024 · DOI：10.3389/fnut.2024.1499438 · 被引用次数：7 · 研究领域：Gout, Hyperuricemia, Uric Acid、Dialysis and Renal Disease Management、Parathyroid Disorders and Treatments

Background The association between serum uric acid (UA) and all-cause and cardiovascular-related mortality in hemodialysis (HD) patients is conflicting. We investigated this association and explored the effect modification of underlying nutritional status, as reflected in the lean tissue index (LTI) and the Geriatric Nutritional Risk Index (GNRI), which serve as markers of muscle mass and nutritional risk in HD patients. Methods A retrospective cohort study was conducted from January 2019 to December 2023. We investigated the association between serum UA and the outcomes using the Cox proportional hazards regression and restricted cubic splines. Subgroup analyses based on the LTI and GNRI were conducted to explore possible effect modification. Results During a mean follow-up of 32.9 months, 876 patients who underwent HD were included in the analysis. The association between serum UA and all-cause mortality showed a non-linear U-shaped pattern ( p = 0.007), with a survival benefit observed for the patients with serum UA levels between 3.4 and 6.8 mg/dL. In the multivariable-adjusted model, the low and high UA groups were associated with a greater risk of all-cause mortality compared to the reference UA group (hazard ratio (HR) =1.24, confidence interval (CI) 1.03–2.12, p = 0.027; HR = 1.09; CI 1.05–2.08. p = 0.012). In the low UA group, a greater risk of mortality was observed in patients with low LTI (<12.3; HR 1.56, 95% CI 1.22–1.82) and GNRI values (<102.1; HR...