Niu Sheng-Wen, Kuo I-Ching, Zhen Yen-Yi, Chang Eddy Essen, Chang Li-Yun, Cheng Chung-Ting, Lin Hugo You-Hsien, Chiu Yi-Wen, Chang Jer-Ming, Hwang Shang-Jyh, Hung Chi-Chih
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
J Pers Med. 2025 Jul 11;15(7):305. doi: 10.3390/jpm15070305.
: Serum uric acid (UA) in end-stage kidney disease (ESKD) patients serves as a critical indicator for nutrition and inflammation, showing a U-shaped association with all-cause mortality. : Our study assessed UA's survival predictive value in 2615 ESKD patients, stratified by the Charlson Comorbidity Index (CCI) into groups of <4 ( = 1107) and ≥4 ( = 1508). : Cox regression revealed distinct patterns. For ESKD patients with CCI < 4, UA levels > 8.6 mg/dL were a mortality risk factor (HR: 1.61, 95% CI: 1.01-2.38) compared to 7.1-7.7 mg/dL. Conversely, in patients with CCI ≥ 4, UA levels < 5.8 mg/dL were a mortality risk factor (HR: 1.53, 95% CI: 1.20-1.95) compared to >8.6 mg/dL. : Higher serum UA in ESKD patients with high comorbidities (CCI ≥ 4) is not a risk factor. Low UA should be prevented across all ESKD patients. A personalized approach using CCI and corresponding serum UA levels offers a key reference for managing UA in hemodialysis patients.
终末期肾病（ESKD）患者的血清尿酸（UA）是营养和炎症的关键指标，与全因死亡率呈U型关联。我们的研究评估了UA在2615例ESKD患者中的生存预测价值，根据查尔森合并症指数（CCI）将患者分为<4组（n = 1107）和≥4组（n = 1508）。Cox回归显示出不同的模式。对于CCI<4的ESKD患者，与7.1 - 7.7mg/dL相比，UA水平>8.6mg/dL是死亡风险因素（HR：1.61，95%CI：1.01 - 2.38）。相反，在CCI≥4的患者中，与>8.6mg/dL相比，UA水平<5.8mg/dL是死亡风险因素（HR：1.53，95%CI：1.20 - 1.95）。高合并症（CCI≥4）的ESKD患者中较高的血清UA不是风险因素。所有ESKD患者都应预防低UA。使用CCI和相应血清UA水平的个性化方法为血液透析患者管理UA提供了关键参考。
