Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe East Road, Zhengzhou, 450052, Henan, China.
Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
Sci Rep. 2024 Jan 5;14(1):673. doi: 10.1038/s41598-023-51010-6.
Controversy surrounds the role of serum uric acid and whether treatment intervention is favorable in retarding the progression of chronic kidney disease (CKD). The association of serum uric acid levels and CKD patient mortality risk needs to be further determined by large sample cohort studies. The National Health and Nutrition Examination Survey participants with CKD from 1998 to 2017 were enrolled in the study. Multivariable Cox regression models were used to reveal the association of serum uric acid concentrations and CKD mortality risks. A total of 9891 CKD patients were enrolled in the study, and 3698 individuals died during the follow-up. Increasing serum uric acid levels are independently relevant to higher mortality risks of CKD patients (HR per SD increase). A restricted cubic spline curve showed a nonlinear association between serum uric acid and CKD mortality risks (p for nonlinearity = 0.046). CKD patients with higher levels of serum uric acid (≥ 5.900 mg/dL) show a significant increase in mortality risks (HR = 1.102, 95% CI 1.043-1.165). Sensitivity analysis demonstrated that the results were stable and robust. High serum uric acid levels (≥ 5.900 mg/dL) may be associated with increased mortality risks in CKD patients.
血清尿酸在慢性肾脏病（CKD）进展中的作用存在争议，治疗干预是否有益仍不明确。需要进一步通过大样本队列研究来确定血清尿酸水平与 CKD 患者死亡风险的关系。
本研究纳入了 1998 年至 2017 年期间患有 CKD 的国家健康和营养检查调查参与者。采用多变量 Cox 回归模型来揭示血清尿酸浓度与 CKD 死亡风险之间的关系。
共有 9891 名 CKD 患者纳入本研究，随访期间有 3698 人死亡。血清尿酸水平升高与 CKD 患者的更高死亡率独立相关（每 SD 增加的 HR）。限制立方样条曲线显示血清尿酸与 CKD 死亡率之间存在非线性关联（非线性检验 p=0.046）。血清尿酸水平较高（≥5.900mg/dL）的 CKD 患者死亡率显著升高（HR=1.102，95%CI 1.043-1.165）。敏感性分析表明结果稳定且具有稳健性。高血清尿酸水平（≥5.900mg/dL）可能与 CKD 患者的死亡率升高有关。
