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Correlation analysis of low-level serum uric acid and cardiovascular events in patients on peritoneal dialysis
Qiuyue Li1, Cong Wu1, Wenli Kuang1
1Department of Nephrology, The First Affiliated Hospital of Nanchang University, 17# Yong wai street, Nanchang, 330006, China.
Insights
Serum uric acid (SUA) levels below 360 μmol/L and above 420 μmol/L are associated with increased cardiovascular event risk in peritoneal dialysis patients. This U-shaped association highlights risks at both low and high SUA levels.
Area of Science:
- Nephrology
- Cardiology
- Clinical Chemistry
Background:
- The relationship between serum uric acid (SUA) and cardiovascular disease (CVD) in peritoneal dialysis (PD) patients is debated, particularly the effect of hypouricemia (HUA).
- This study investigates the influence of low serum uric acid levels on cardiovascular (CV) events in PD patients.
Purpose of the Study:
- To examine the association between varying serum uric acid levels and the risk of cardiovascular events in patients undergoing peritoneal dialysis.
- To clarify the impact of hypouricemia on cardiovascular outcomes in PD patients.
Main Methods:
- A retrospective cohort study involving 728 PD patients from February 2010 to May 2019.
- Patients were categorized into four groups based on serum uric acid levels (μmol/L) after six months of PD: <360, 360-420, 420-480, and ≥480.
- Logistic regression and Kaplan-Meier methods were used to analyze the correlation between SUA levels and CV event risk.
Main Results:
- A total of 728 patients (55.4% male, average age 48.66 years) were analyzed, with 158 (21.7%) experiencing CV events.
- Multivariate COX regression revealed that SUA levels <360 μmol/L (Group 1), 420-480 μmol/L (Group 3), and ≥480 μmol/L (Group 4) were independent risk factors for CV events.
- Kaplan-Meier analysis showed significantly higher CV event risk in Groups 1, 3, and 4. Restricted cubic spline analysis indicated a non-linear, U-shaped association between SUA levels and CV event risk.
Conclusions:
- Serum uric acid levels below 360 μmol/L are associated with an increased risk of cardiovascular events in PD patients.
- An U-shaped association exists between SUA levels and the risk of CV events in patients undergoing PD.
- Both low (<360 μmol/L) and high (≥420 μmol/L) SUA levels are significant risk factors for CV events in long-term PD patients.
Background:
The impact of serum uric acid (SUA) on development of cardiovascular disease (CVD) in patients undergoing peritoneal dialysis (PD) remains controversial, especially the impact of hypouricemia (HUA) on CVD. The aim of our study was to investigate the influence of low-level SUA on cardiovascular (CV) events in PD patients.
Methods:
A retrospective cohort study was conducted.728 PD patients from February 1, 2010 to May 31, 2019 were enrolled. All demographic and laboratory data were collected at baseline and 6 months after PD treatment. The study cohort was divided into four groups according to SUA level (μmol/L) after 6 months of PD: Group1 (< 360), Group2 (360-420), Group3 (420-480), Group4 (≥ 480). The clinical characteristics of each group were analyzed. With Group2 as reference, logistic regression analysis was performed to investigate the correlation between SUA levels and risk of CV events in patients undergoing PD. Use Kaplan-Meier method to generate CV events risk graph.
Results:
728 patients were enrolled in this study, including 403 (55.4%) males and 325 (44.6%) females, with an average age of 48.66 ± 13.98 years; of which 158 (21.7%) patients developed CV events. Multivariate COX regression showed that after adjusting for multiple clinical factors, Group1 (HR = 1.92, 95% CI 1.17-3.15, P = 0.01), Group3 (HR = 1.89, 95% CI 1.13-3.15, P = 0.015), and Group4 (HR = 2.38, 95% CI 1.35-4.19, P = 0.003) are all independent risk factors for developing CV events. The Kaplan-Meier risk curve of CV events showed that the risk of CV events in the Group1, Group3 and Group4 were significantly higher (Log-Rank = 12.67; P = 0.005). Restricted cubic spline (RCS) showed that SUA level is non-linearly associated with the risk of CV events, showing an U-shaped curve ([Formula: see text]=13.3 P = 0.01).
Conclusions:
Our study suggested that patients with SUA level less than 360 μmol/L also exhibited the higher risk for developing CV events, an U-shaped association between SUA level and risk of CV events in patients undergoing PD. Both SUA levels below 360 μmol/L and above 420 μmol/L were found to be significant risk factors for developing CV events in patients undergoing long-term PD.
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