维持性血液透析尿毒症患者高尿酸血症的患病率及其危险因素

Hyperuricemia prevalence and its risk factors in uremic patients undergoing maintenance hemodialysis.

作者信息

Zhang Meng, Huang Gaoqiankun, Bao Xiaorong, Yang Qingmei

机构信息

Department of Nephrology, Jinshan Hospital Affiliated to Fudan University, Shanghai, China.

Nephrology Department, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.

出版信息

BMC Nephrol. 2025 Jan 30;26(1):46. doi: 10.1186/s12882-025-03978-8.

DOI:10.1186/s12882-025-03978-8

PMID:39885381

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11780984/

Abstract

BACKGROUND

To explore the prevalence of hyperuricemia and its associated factors in uremic patients undergoing maintenance hemodialysis (MHD).

METHODS

Two hundred two uremic patients undergoing MHD for ≥ 3 months, in Jinshan Hospital, Fudan University, were enrolled. Pre-dialysis blood samples were tested during March 1st, 2023 to April 30th, 2023. Demographic characteristics were recorded. The prevalence of hyperuricemia, defined as serum uric acid (SUA) ≥ 420 μmol/L, was investigated. Individuals were divided into hyperuricemia (HUA) and non-hyperuricemia (n-HUA) groups. The demographic characteristics, residual kidney function, nutritional status, acid-base metabolism, electrolyte and lipid metabolism were compared between groups. The associated factors for hyperuricemia in MHD patients were identified by logistic regression.

RESULTS

The median SUA level of the enrolled patients was 458.50 (392.25, 510.75) μmol/L. 134 (66.34%) candidates met the diagnostic criteria of hyperuricemia. The median SUA level in HUA group was 491.00 (459.50, 543.50) μmol/L. Compared to those in n-HUA group, subjects in HUA group showed lower estimated glomerular filtration rate and blood CO level, but higher levels of body mass index, geriatric nutritional risk index, plasma phosphate, potassium, pre-albumin, albumin, serum creatinine (Scr) and urea nitrogen. Logistic regression indicated that Scr (OR 1.002, 95% CI 1.001-1.004, P = 0.003), albumin (OR 1.165, 95%CI 1.011-1.342, P = 0.035), and blood potassium (OR 1.673, 95% CI 1.009-2.773, P = 0.046) were associated factors for hyperuricemia in uremic patients undergoing MHD.

CONCLUSION

Hyperuricemia was highly prevalent among uremic MHD patients. Elevated levels of Scr, albumin and plasma potassium were independent associated factors for hyperuricemia.

摘要

背景

探讨维持性血液透析（MHD）尿毒症患者高尿酸血症的患病率及其相关因素。

方法

纳入复旦大学附属金山医院202例接受MHD≥3个月的尿毒症患者。于2023年3月1日至2023年4月30日期间采集透析前血样进行检测，记录人口统计学特征。对血清尿酸（SUA）≥420μmol/L定义的高尿酸血症患病率进行调查。将患者分为高尿酸血症（HUA）组和非高尿酸血症（n-HUA）组，比较两组的人口统计学特征、残余肾功能、营养状况、酸碱代谢、电解质及脂质代谢情况。通过逻辑回归分析确定MHD患者高尿酸血症的相关因素。

结果

入选患者的SUA中位数水平为458.50（392.25，510.75）μmol/L。134例（66.34%）患者符合高尿酸血症诊断标准。HUA组SUA中位数水平为491.00（459.50，543.50）μmol/L。与n-HUA组相比，HUA组患者的估计肾小球滤过率和血二氧化碳水平较低，但体重指数、老年营养风险指数、血浆磷、钾、前白蛋白、白蛋白、血清肌酐（Scr）和尿素氮水平较高。逻辑回归分析显示，Scr（比值比[OR]1.002，95%置信区间[CI]1.001 - 1.004，P = 0.003）、白蛋白（OR 1.165，95%CI 1.011 - 1.342，P = 0.035）和血钾（OR 1.673，95%CI 1.009 - 2.773，P = 0.046）是MHD尿毒症患者高尿酸血症的相关因素。