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Hyperuricemia is an independent risk factor for mortality only if chronic kidney disease is present
Wookyung Chung1, Ae Jin Kim, Han Ro
1Division of Nephrology, Department of Internal Medicine, Gachon University of Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.
Insights
Hyperuricemia increases mortality risk in patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI). This association was not observed in patients without CKD, highlighting the importance of kidney function.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Hyperuricemia is a known risk factor for renal and cardiovascular diseases.
- Its impact on mortality, particularly concerning kidney function, requires further investigation.
Purpose of the Study:
- To investigate the association between hyperuricemia and all-cause mortality in patients undergoing percutaneous coronary intervention (PCI).
- To examine the interaction between hyperuricemia, kidney function, and mortality risk.
Main Methods:
- Retrospective analysis of 4,842 patients undergoing PCI (2003-2009).
- Propensity score matching created a cohort of 693 pairs of patients with and without hyperuricemia.
- Analysis stratified by the presence or absence of chronic kidney disease (CKD).
Main Results:
- Hyperuricemia was present in 23.8% of the study population.
- Hyperuricemia was associated with increased all-cause mortality (HR 1.655; 95% CI 1.109-2.468) in the matched cohort.
- The association between hyperuricemia and mortality was significant in patients with CKD (HR 2.080) but not in those without CKD (HR 1.592), with a significant interaction (p=0.001).
Conclusions:
- Hyperuricemia is an independent risk factor for all-cause mortality in patients with CKD undergoing PCI.
- This risk is not significant in patients without CKD, underscoring the role of kidney function in this association.
Background/Aims:
Hyperuricemia has been considered a risk factor for renal disease and cardiovascular disease. However, the potential contribution of hyperuricemia to mortality remains uncertain, and the results in the available literature vary according to kidney function. The aim of this study was to determine the association between hyperuricemia and mortality in patients undergoing percutaneous coronary intervention (PCI) across the interaction of kidney function.
Method:
We retrospectively reviewed patients who underwent PCI from 2003 to 2009. Propensity scores for hyperuricemia (>7 mg/dl for males and >6 mg/dl for females) were used to assemble a matched cohort of 693 pairs of patients with and without hyperuricemia for analysis from the 3,201 patients who fulfilled the inclusion criteria among the 4,842 patients who underwent PCI.
Results:
Of the 3,201 patients who underwent PCI and for whom data were available regarding their baseline serum uric acid level, 763 (23.8%) had hyperuricemia. The hyperuricemia-associated hazard ratios (HRs) [95% confidence intervals (CIs)] for all-cause mortality were 1.780 (1.270-2.495) in the unmatched cohort and 1.655 (1.109-2.468) in the matched cohort. The HRs (95% CI) for all-cause mortality among those with and without chronic kidney disease (CKD) were 2.080 (1.318-3.283) and 1.592 (0.778-3.256), respectively (p for interaction, 0.001).
Conclusions:
Hyperuricemia is an independent risk factor for all-cause mortality in those patients with CKD but not in those without CKD.
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