Department of cardiovascular disease, Taichung Veterans General Hospital, Taichung, Taiwan.
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.
BMC Nephrol. 2022 Apr 22;23(1):157. doi: 10.1186/s12882-022-02755-1.
Hyperuricemia and diabetes mellitus (DM) are associated with increased mortality risk in patients with chronic kidney disease (CKD). Here we aimed to evaluate the independent and joint risks of these two conditions on mortality and end stage kidney disease (ESKD) in CKD-patients.
This retrospective cohort study enrolled 4380 outpatients (with CKD stage 3-5) with mortality and ESKD linkage during a 7-year period (from 2007 to 2013). All-causes mortality and ESKD risks were analyzed by multivariable-adjusted Cox proportional hazards models (adjusted for age, sex, smoke, previous coronary arterial disease, blood pressure, and medications for hyperlipidemia, hyperuricemia and renin-angiotensin system inhibitors).
Overall, 40.5% of participants had DM and 66.4% had hyperuricemia. In total, 356 deaths and 932 ESKD events occurred during the 7 years follow-up. With the multivariate analysis, increased risks for all-cause mortality were: hyperuricemia alone, HR = 1.48 (1-2.19); DM alone, and HR = 1.52 (1.02-2.46); DM and hyperuricemia together, HR = 2.12 (1.41-3.19). Similar risks for ESKD were: hyperuricemia alone, HR = 1.34 (1.03-1.73); DM alone, HR = 1.59 (1.15-2.2); DM and hyperuricemia together, HR = 2.46 (1.87-3.22).
DM and hyperuricemia are strongly associated with higher all-cause mortality and ESKD risk in patients with CKD stage 3-5. Hyperuricemia is similar to DM in terms of risk for all-cause mortality and ESKD. DM and hyperuricemia when occurred together further increase both risks of all-cause mortality and ESKD.
高尿酸血症和糖尿病（DM）与慢性肾脏病（CKD）患者的死亡率增加相关。在这里，我们旨在评估这两种疾病对 CKD 患者的死亡率和终末期肾病（ESKD）的独立和联合风险。
本回顾性队列研究纳入了 4380 名在 7 年期间（2007 年至 2013 年）与死亡率和 ESKD 相关的 CKD 阶段 3-5 的门诊患者。使用多变量调整的 Cox 比例风险模型（根据年龄、性别、吸烟、既往冠状动脉疾病、血压以及降脂、降尿酸和肾素-血管紧张素系统抑制剂的药物进行调整）分析全因死亡率和 ESKD 风险。
总体而言，40.5%的参与者患有 DM，66.4%患有高尿酸血症。在 7 年的随访期间，共发生 356 例死亡和 932 例 ESKD 事件。在多变量分析中，全因死亡率增加的风险为：高尿酸血症单独，HR=1.48（1-2.19）；DM 单独，HR=1.52（1.02-2.46）；DM 和高尿酸血症一起，HR=2.12（1.41-3.19）。ESKD 的相似风险为：高尿酸血症单独，HR=1.34（1.03-1.73）；DM 单独，HR=1.59（1.15-2.2）；DM 和高尿酸血症一起，HR=2.46（1.87-3.22）。
DM 和高尿酸血症与 CKD 阶段 3-5 患者的全因死亡率和 ESKD 风险增加密切相关。高尿酸血症在全因死亡率和 ESKD 风险方面与 DM 相似。当 DM 和高尿酸血症同时发生时，全因死亡率和 ESKD 的风险进一步增加。
