Internal Medicine Department, Zafra County Hospital, Badajoz, Spain.
Nephrology Department, University Hospital "Infanta Cristina", Badajoz, Spain.
Int J Neurosci. 2021 Jun;131(6):609-614. doi: 10.1080/00207454.2020.1750395. Epub 2020 Apr 13.
The role of serum uric acid (SUA) after stroke is controversial and can be influenced by renal disease.
to analyse the role of SUA in the acute phase of stroke based on the presence/absence of kidney disease and cardiovascular outcome.
Retrospective cohort of a stroke registry followed-up for one year. The sample was divided according to the presence of renal disease defined by haematocrit, urea and gender (HUGE) formula, along with a SUA cut-off point obtained by receiver operating characteristic curves based on SUA levels and on the primary end-point occurrence.
500 patients (268, 53.6% males) were analysed. Renal disease was present in 14.8% patients. The SUA cut-off for patients with renal disease was 404.46 μmol/L and 344.98 μmol/L for the remainder. Patients with higher SUA levels had decreased neurological disabilities (p = 0.04) and higher comorbidity (p = 0.00). Over a period of 42.3 (19) weeks, a primary end-point occurred in 17.4% patients. In the adjusted Cox model, SUA was associated with the primary end-point (HR 1.45, 95%CI 1.17-1.81, p = 0.01). Separated by the presence/absence of renal disease, SUA levels were associated with the primary endpoint for patients with renal disease (HR 1.29, 95%CI 1.06-1.58, p = 0.01) and for all other patients (HR 1.42, 95%CI 1.2-1.7, p = 0.00).
We observed a relationship between SUA levels and a negative cardiovascular outcome after ischaemic stroke both in patients with and without renal disease, with the worst outcomes occurring in patients with renal insufficiency.
血清尿酸（SUA）在中风后的作用存在争议，并且可能受到肾脏疾病的影响。
根据是否存在肾脏疾病和心血管结局来分析中风急性期 SUA 的作用。
对中风登记处进行的回顾性队列研究，随访一年。根据基于血细胞比容、尿素和性别（HUGE）公式的肾脏疾病和通过基于 SUA 水平和主要终点发生的受试者工作特征曲线获得的 SUA 截断值将样本进行分组。
分析了 500 名患者（268 名，53.6%为男性）。14.8%的患者存在肾脏疾病。患有肾脏疾病的患者的 SUA 截断值为 404.46μmol/L，其余患者的截断值为 344.98μmol/L。SUA 水平较高的患者神经功能缺损程度较低（p=0.04）且合并症较多（p=0.00）。在 42.3（19）周的时间内，17.4%的患者发生了主要终点事件。在调整后的 Cox 模型中，SUA 与主要终点相关（HR 1.45，95%CI 1.17-1.81，p=0.01）。根据是否存在肾脏疾病进行分组，SUA 水平与患有肾脏疾病的患者的主要终点相关（HR 1.29，95%CI 1.06-1.58，p=0.01）和所有其他患者的主要终点相关（HR 1.42，95%CI 1.2-1.7，p=0.00）。
我们观察到，在患有和不患有肾脏疾病的患者中，SUA 水平与缺血性中风后的心血管不良结局之间存在相关性，肾脏功能不全的患者结局最差。
