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Uric acid and long-term outcomes in CKD.
Magdalena Madero1, Mark J Sarnak, Xuelei Wang
1Department of Medicine, Division of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
Summary
High uric acid levels (hyperuricemia) in chronic kidney disease (CKD) patients are linked to increased mortality risk. Hyperuricemia independently predicts all-cause and cardiovascular disease mortality but not kidney failure in stages 3-4 CKD.
Area of Science:
- Nephrology
- Cardiology
- Epidemiology
Background:
- Hyperuricemia is common in chronic kidney disease (CKD) patients.
- Limited data exist on uric acid's long-term impact on CKD outcomes.
Purpose of the Study:
- To investigate the association between baseline uric acid levels and long-term outcomes in patients with stages 3-4 CKD.
- To determine if uric acid is an independent risk factor for mortality and kidney failure.
Main Methods:
- A cohort study analyzing data from 838 patients in the Modification of Diet in Renal Disease (MDRD) Study.
- Evaluated baseline uric acid levels against all-cause mortality, cardiovascular disease (CVD) mortality, and kidney failure over a median 10-year follow-up.
Main Results:
- The highest tertile of uric acid was associated with a 57% increased risk of all-cause mortality (HR, 1.57) and a trend towards CVD mortality.
- Each 1-mg/dL increase in uric acid correlated with a 17% higher risk of all-cause mortality and a 16% higher risk of CVD mortality.
- No significant association was found between uric acid levels and kidney failure.
Conclusions:
- Hyperuricemia is an independent risk factor for all-cause and cardiovascular disease mortality in patients with stages 3-4 CKD.
- Uric acid levels do not appear to predict kidney failure in this population.
- Findings are primarily generalizable to younger, predominantly non-diabetic white CKD patients.
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