Resident of Internal Medicine, Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran.
Associated professor of nephrology. Shohada Tajrish Hospital, Shahid Beheshti University of Medical Science, TehranIran.
Rom J Intern Med. 2022 Jun 14;60(2):115-122. doi: 10.2478/rjim-2021-0039. Print 2022 Jun 1.
Hyperuricemia is associated with an increased risk of cardio-and cerebrovascular disease (CVD) in general population. However, in the hemodialysis (HD) patients, low serum uric acid (SUA) increases the risk of mortality. Considering that CVD is the principal cause of death among maintenance HD patients, the present study aimed to determine the predictive value of SUA for CVD outcome in this population. In this two-year follow-up prospective study, 205 outpatients under maintenance HD were enrolled from March 2017 to 2020. Patients' demographic data, underlying diseases, and the results of serum tests, as well as two-year follow-up results of CVD events and mortality were recorded. A total of 130 (63%) patients were eligible for analysis; 62.9% were male; mean age of participants was 59±13years. At follow-up, coronary artery disease was observed in 43.2%, peripheral artery disease in 26.5%, and cerebrovascular disease in 20.5%; angiography was required in 52.3% and 4.5% died of CVD. SUA was ≤5.4 mg/dL in 52 patients, 5.5-6.1 mg/dL in 19, and ≥6.2 mg/dL in 59 patients with significant difference based on mean age, sex distribution, occurrence of cerebrovascular disease and cardiovascular mortality (P<0.05). Patients with cerebrovascular disease had a significantly lower SUA levels (P=0.006). Logistic regression showed the significant effect of SUA on the occurrence of cerebrovascular disease (P=0.008). Low SUA can predict two-year incidence of cerebrovascular disease in HD patients. However, SUA levels did not show significant predictive effect on two-year coronary events, peripheral artery disease and cardiovascular mortality.
高尿酸血症与一般人群中心血管疾病（CVD）的风险增加有关。然而，在血液透析（HD）患者中，低血清尿酸（SUA）会增加死亡率。考虑到 CVD 是维持性 HD 患者死亡的主要原因，本研究旨在确定 SUA 对该人群 CVD 结局的预测价值。在这项为期两年的前瞻性研究中，我们招募了 2017 年 3 月至 2020 年期间接受维持性 HD 的 205 名门诊患者。记录了患者的人口统计学数据、基础疾病以及血清检查结果，以及 CVD 事件和死亡率的两年随访结果。共有 130 名（63%）患者符合分析条件；62.9%为男性；参与者的平均年龄为 59±13 岁。在随访期间，观察到 43.2%的患者患有冠状动脉疾病，26.5%的患者患有外周动脉疾病，20.5%的患者患有脑血管疾病；52.3%的患者需要进行血管造影，4.5%的患者死于 CVD。52 名患者的 SUA≤5.4mg/dL，19 名患者的 SUA 为 5.5-6.1mg/dL，59 名患者的 SUA≥6.2mg/dL，平均年龄、性别分布、脑血管疾病和心血管死亡率的差异有统计学意义（P<0.05）。患有脑血管疾病的患者 SUA 水平明显较低（P=0.006）。Logistic 回归显示 SUA 对脑血管疾病发生的显著影响（P=0.008）。低 SUA 可预测 HD 患者两年内发生脑血管疾病。然而，SUA 水平对两年内发生的冠状动脉事件、外周动脉疾病和心血管死亡率没有显著的预测作用。
