Uric acid to high-density lipoprotein cholesterol ratio predicts cardiovascular mortality in patients on peritoneal
Ruihua Liu1, Yuan Peng1, Haishan Wu1
1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China; Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, 510080, China.
Insights
An elevated uric acid to high-density lipoprotein cholesterol ratio (UHR) predicts higher risks of death in peritoneal dialysis (PD) patients. This finding highlights UHR as a potential marker for cardiovascular mortality in PD populations.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- Serum uric acid (UA) and high-density lipoprotein cholesterol (HDL-C) are established cardiovascular mortality risk factors.
- The UA to HDL-C ratio (UHR) has shown predictive value in diabetes but remains unstudied in peritoneal dialysis (PD) patients.
Purpose of the Study:
- To investigate the association between the UA to HDL-C ratio (UHR) and cardiovascular (CV) mortality in patients undergoing peritoneal dialysis (PD).
Main Methods:
- A retrospective cohort study included 1953 incident PD patients followed for a median of 61.3 months.
- Patients were stratified into quartiles based on baseline UHR.
- Multivariate Cox regression analysis was used to assess the association between UHR and mortality outcomes.
Main Results:
- The mean baseline UHR was 16.4 ± 6.7%.
- Elevated UHR, particularly the highest quartile, was significantly associated with increased all-cause (HR 1.35) and CV mortality (HR 1.46) compared to the second quartile.
- Subgroup analyses indicated a stronger association in elderly PD patients (≥65 years), those with malnutrition, diabetes, or a history of cardiovascular disease.
Conclusions:
- An elevated UHR is a significant predictor of increased all-cause and cardiovascular mortality in peritoneal dialysis patients.
- UHR may serve as a valuable prognostic marker for cardiovascular risk stratification in this vulnerable population.
Background And Aims:
Serum uric acid (UA) and high-density lipoprotein cholesterol (HDL-C) disorders are both considered as risk factors of cardiovascular mortality. The predictive value of UA to HDL-C ratio (UHR) has been validated in diabetes. However, association of UHR with cardiovascular (CV) mortality is undetermined in peritoneal dialysis (PD) patients.
Methods And Results:
In this retrospective cohort study, we enrolled 1953 eligible incident patients who commenced PD treatment on our hospital from January 1, 2006 to December 31, 2015, and followed up until December 31, 2019. Of the participants, 14.9% were older than 65 years (mean age 47.3 ± 15.2 years), 24.6% were diabetics, and 59.4% were male. Patients were categorized into quartiles according to baseline UHR level. Multivariate Cox Proportional Regression analysis was applied to explore the association of UHR with mortality. Overall, 567 patients died during a median follow-up period of 61.3 months, of which 274 (48.3%) were attributed to CV death. The mean baseline UHR was 16.4 ± 6.7%. Compared to quartile 2 UHR, hazard ratios (HRs) for the highest quartile UHR were 1.35 (95% confidence interval [CI] 1.06-1.78; P = 0.017) and 1.46 (95% CI 1.00-2.12; P = 0.047) for all-cause and CV mortality, respectively. Subgroup analysis showed that association of UHR with CV mortality was remarkable among PD patients with age ≥65 years, malnutrition (albumin <35 g/L), diabetes, and CVD history.
Conclusions:
An elevated UHR predicted increased risk of all-cause and CV mortality in PD patients.
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