Serum uric acid and mortality in chronic kidney disease: A systematic review and meta-analysis

Area of Science:

• Nephrology
• Clinical Biochemistry
• Epidemiology

Background:

• Inconsistent findings exist regarding serum uric acid and mortality in chronic kidney disease (CKD).
• Clarifying this association is crucial for patient outcomes in CKD.
• This study addresses the need for a comprehensive analysis.

Purpose of the Study:

• To systematically evaluate the association between serum uric acid levels and mortality in patients with CKD.
• To quantify the risk of mortality associated with elevated serum uric acid in CKD.
• To inform clinical practice and future research directions.

Main Methods:

• A systematic literature search was conducted across major databases (MEDLINE, Web of Science).
• Data from 24 studies involving 25,453 CKD patients were included.
• Random-effects models were used for meta-analysis and dose-response analysis.

Main Results:

• The highest serum uric acid levels were significantly linked to a 1.52-fold increased mortality risk (HR, 1.52; 95% CI, 1.33-1.73).
• A linear dose-response relationship was observed between serum uric acid and mortality risk.
• Each 1 mg/dL increase in serum uric acid correlated with an 8% higher mortality risk (HR, 1.08; 95% CI, 1.04-1.11).

Conclusions:

• Elevated serum uric acid is a significant risk factor for mortality in patients with chronic kidney disease.
• Targeting serum uric acid levels may potentially improve survival in CKD patients.
• Further randomized controlled trials are warranted to confirm the therapeutic benefit of uric acid lowering.