高尿酸血症与住院患者的急性肾损伤和全因死亡率相关。

Hyperuricemia is associated with acute kidney injury and all-cause mortality in hospitalized patients.

机构信息

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.

Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea.

出版信息

Nephrology (Carlton). 2019 Jul;24(7):718-724. doi: 10.1111/nep.13559. Epub 2019 May 2.

DOI:10.1111/nep.13559

PMID:30644622

Abstract

AIM

Hyperuricemia is a risk factor for high morbidity and mortality in several diseases. However, the relationship between uric acid (UA) and the risk of acute kidney injury (AKI) and mortality remain unresolved in hospitalized patients.

METHODS

Data from 18 444 hospitalized patients were retrospectively reviewed. The odds ratio (OR) for AKI and the hazard ratio (HR) for all-cause mortality were calculated based on the UA quartiles after adjustment for multiple variables. All analyses were performed after stratification by sex.

RESULTS

The fourth quartile group (male, UA > 6.7 mg/dL; female, UA > 5.4 mg/dL) showed a higher risk of AKI compared with the first quartile group (male, UA < 4.5 mg/dL; female, UA < 3.6 mg/dL), with the following OR: 3.2 (2.55-4.10) in males (P < 0.001); and 3.1 (2.40-4.19) in females (P < 0.001). There were more patients who did not recover from AKI in the fourth quartile compared with the first quartile, with the following OR: 2.0 (1.32-3.04) in males (P = 0.001) and 2.4 (1.43-3.96) in females (P = 0.001). The fourth quartile group had a higher risk of all-cause mortality compared with the first quartile group, with the following HR: 1.4 (1.20-1.58) in males (P < 0.001) and 1.2 (1.03-1.46) in females (P = 0.019). The in-hospital mortality risk was also higher in the fourth quartile compared with the first quartile, which was significant only in males (OR, 2.1 (1.33-3.31) (P = 0.002)).

CONCLUSION

Hyperuricemia increases the risks of AKI and all-cause mortality in hospitalized patients.

摘要

目的

高尿酸血症是多种疾病高发病率和高死亡率的一个危险因素。然而，尿酸（UA）与急性肾损伤（AKI）风险和全因死亡率之间的关系在住院患者中仍未得到解决。

方法

回顾性分析了 18444 例住院患者的数据。根据 UA 四分位间距，在调整多个变量后，计算 AKI 的优势比（OR）和全因死亡率的风险比（HR）。所有分析均按性别分层后进行。

结果

第四四分位组（男性，UA＞6.7mg/dL；女性，UA＞5.4mg/dL）与第一四分位组（男性，UA＜4.5mg/dL；女性，UA＜3.6mg/dL）相比，AKI 的风险更高，OR 分别为 3.2（2.55-4.10）（P＜0.001）和 3.1（2.40-4.19）（P＜0.001）。与第一四分位组相比，第四四分位组中未从 AKI 中恢复的患者更多，OR 分别为 2.0（1.32-3.04）（P=0.001）和 2.4（1.43-3.96）（P=0.001）。与第一四分位组相比，第四四分位组的全因死亡率更高，HR 分别为 1.4（1.20-1.58）（P＜0.001）和 1.2（1.03-1.46）（P=0.019）。与第一四分位组相比，第四四分位组的住院死亡率也更高，仅在男性中具有统计学意义（OR，2.1（1.33-3.31）（P=0.002））。