Li Lu, Zhang Hongxia, Zhang Botao, Yang Fangyuan, Wang Mengting, Qiu Wenlong, Fu Lina, Chen Menghua, Tian Na
Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
Ningxia Nephrology Disease Clinical Research Center, Yinchuan, Ningxia, China.
Ther Apher Dial. 2025 Jun;29(3):479-490. doi: 10.1111/1744-9987.14252. Epub 2025 Feb 4.
The relationship between time-averaged serum uric acid (TA-SUA) levels and prognosis in peritoneal dialysis (PD) patients are rarely discussed.
This was a retrospective cohort study. PD patients recruited from January 1, 2011, to December 31, 2020, were included. Baseline and follow-up uric acid levels over 1 year were collected to calculate time-averaged serum uric acid (TA-SUA) levels. Patients were divided into four groups based on TA-SUA quartiles: Q1 (<5.1 mg/dl), Q2 (5.1-5.8 mg/dl), Q3 (5.8-6.8 mg/dl), and Q4 (>6.8 mg/dl).
A total 487 PD patients with a mean age of 52.0 ± 14.2 were enrolled, including114 (23.4%) diabetes. Q1 (n = 121, 24.8%), Q2 (n = 118, 24.2%), Q3 (n = 125, 25.7%), and Q4 (n = 123, 25.3%). The Q1 group exhibited characteristics of increased age, malnutrition, and a higher prevalence of diabetes. During the 48.1 months follow-up time, 197 (35.8%) died, 109 (55.3%) cardiovascular disease (CVD), 38 (19.3%) infections. Kaplan-Meier analysis revealed that both all-cause mortality and cardiovascular mortality were significantly higher in the Q1 and Q4 groups (log-rank = 24.373, p < 0.001). COX regression analysis showed that decreased TA-SUA level was an independent risk factor for all-cause mortality in PD patients after adjustment for confounding factors. Each 1 mg/dl decrease in TA-SUA level was associated with a 23.46% increase in all-cause mortality (HR = 0.81, 95% CI, 0.71-0.94; p = 0.004*). Lower serum albumin level was associated with increased all-cause mortality.
PD patients with lower TA-SUA were older and had a higher proportion of diabetes and malnourishment than those with higher TA-SUA. Long-term exposure to low TA-SUA levels was an independent predictor of all-cause and cardiovascular mortality in PD patients.
腹膜透析（PD）患者的时间平均血清尿酸（TA-SUA）水平与预后之间的关系鲜有讨论。
这是一项回顾性队列研究。纳入2011年1月1日至2020年12月31日招募的PD患者。收集基线和随访1年以上的尿酸水平，以计算时间平均血清尿酸（TA-SUA）水平。根据TA-SUA四分位数将患者分为四组：Q1（<5.1mg/dl）、Q2（5.1-5.8mg/dl）、Q3（5.8-6.8mg/dl）和Q4（>6.8mg/dl）。
共纳入487例平均年龄为52.0±14.2岁的PD患者，其中114例（23.4%）患有糖尿病。Q1组（n=121，24.8%）、Q2组（n=118，24.2%）、Q3组（n=125，25.7%）和Q4组（n=123，25.3%）。Q1组表现出年龄增加、营养不良和糖尿病患病率较高的特征。在48.1个月的随访期内，197例（35.8%）死亡，109例（55.3%）发生心血管疾病（CVD），38例（19.3%）发生感染。Kaplan-Meier分析显示，Q1组和Q4组的全因死亡率和心血管死亡率均显著较高（对数秩=24.373，p<0.001）。COX回归分析显示，在调整混杂因素后，TA-SUA水平降低是PD患者全因死亡的独立危险因素。TA-SUA水平每降低1mg/dl，全因死亡率增加23.46%（HR=0.81，95%CI，0.71-0.94；p=0.004*）。较低的血清白蛋白水平与全因死亡率增加相关。
与TA-SUA水平较高的患者相比，TA-SUA水平较低的PD患者年龄更大，糖尿病和营养不良的比例更高。长期暴露于低TA-SUA水平是PD患者全因和心血管死亡率的独立预测因素。
