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Uric acid and left ventricular hypertrophy: another relationship in hemodialysis patients

Gjulsen Selim1, Olivera Stojceva-Taneva1, Liljana Tozija1

  • 1University Clinic of Nephrology, Ss. Cyril and Methodius University Skopje, Republic of North Macedonia.

Clinical Kidney Journal
|February 24, 2021
PubMed

Insights

Low serum uric acid (UA) levels in hemodialysis (HD) patients are linked to increased mortality and left ventricular hypertrophy (LVH). This finding contrasts with general population studies, suggesting unique risks in HD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Biochemistry

Background:

  • Serum uric acid (UA) impact on hemodialysis (HD) patient outcomes is debated.
  • Previous research shows conflicting associations between UA levels and mortality/morbidity in the general population.
  • Understanding UA's role in HD patients is crucial for managing cardiovascular risks.

Purpose of the Study:

  • To investigate the association between serum UA levels and mortality in HD patients.
  • To evaluate the relationship between serum UA levels and left ventricular hypertrophy (LVH) in HD patients.
  • To compare UA's impact in HD patients with its known effects in the general population.

Main Methods:

  • A longitudinal study of 225 prevalent HD patients over 60 months.
  • Patients categorized into low (<400 µmol/L), intermediate (400-450 µmol/L), and high (>450 µmol/L) follow-up-averaged UA (FA-UA) groups.
  • LVH assessed via echocardiography using left ventricular mass index (LVMI); mortality tracked over 5 years.

Main Results:

  • Higher FA-UA correlated with better nutritional status, higher hemoglobin, and lower C-reactive protein and LVMI.
  • Low FA-UA group showed a significant association with increased all-cause mortality (HR 1.75, P=0.041) compared to the reference group.
  • Low FA-UA was significantly associated with LVH risk (OR 2.82, P=0.002) even after adjustment for covariates.

Conclusions:

  • Low serum UA is identified as a mortality risk factor in HD patients.
  • Low serum UA is significantly associated with left ventricular hypertrophy in HD patients.
  • These findings diverge from general population studies, warranting further investigation into UA's role in HD patient outcomes.
Abstract

Keywords:
chronic hemodialysisleft ventricular hypertrophy mortalityuric acid

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