Journal
AMERICAN JOURNAL OF NEPHROLOGY
Volume 29, Issue 2, Pages 79-85Publisher
KARGER
DOI: 10.1159/000151292
Keywords
Hypoalbuminemia; Hemodialysis, comorbidity; Serum uric acid, mortality
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Funding
- US Public Health [DK-52121, HL-68607]
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [R01HL068607] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [R01DK052121] Funding Source: NIH RePORTER
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Background: A reverse epidemiology of classic cardiovascular risk factors was observed in hemodialysis patients with a high comorbidity burden. We hypothesized that uric acid, a novel cardiovascular risk factor, also has an altered association with survival in these patients. Methods: A retrospective study was conducted on 168 consecutive outpatient hemodialysis patients over a 6-year period. Serum uric acid, albumin levels and relevant laboratory information were recorded monthly. The disease severity was assessed using Comorbidity Index (CoI) scores. Patients were stratified into 3 groups according to their serum uric acid concentrations: group I was the lowest quintile, group II was the middle 3 quintiles and group III was the highest quintile. The risks of death were calculated utilizing a Cox regression model. Results: Using group II as a reference group, the hazard ratio of group I was 2.23 [95% confidence interval (CI) 1.21-4.11, p = 0.01] and group III was 0.89 (95% CI 0.47-1.71, p = 0.74). The serum uric acid levels correlated inversely with CoI scores (r = -0.31, 95% CI -0.44 to -0.17, p < 0.0001) and positively with serum albumin levels (r = 0.35, 95% CI 0.21-0.48, p < 0.0001). Conclusion: Low serum uric acid is a mortality risk factor in incident hemodialysis patients with a high comorbidity burden and hypoalbuminemia. Copyright (C) 2008 S. Karger AG, Basel
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