Uric acid levels and all-cause mortality in peritoneal dialysis patients.

BACKGROUND

Epidemiological studies have shown that hyperuricemia is associated with all-cause and cardiovascular mortality in chronic kidney disease (CKD) and hemodialysis patients. Our study investigated the influence of serum uric acid (UA) levels on survival in peritoneal dialysis (PD) patients.

METHODS

This was a retrospective study involving 156 subjects who had undergone PD. The patient demographics, etiology of ESRD, comorbid conditions and other laboratory parameters were collected. The subjects were divided into three groups according to their serum UA concentrations (group 1, the lowest quartile; group 2, the middle quartiles; group 3, the highest quartile). The risk of death was calculated using a multivariate Cox regression model.

RESULTS

There were 41 deaths during a follow-up period of 31.3±17.5 months. Compared with group 2, which had a mortality rate of 5.7 per 1000 person-months, the mortality rates were higher in group 1 (14.3 per 1000 person-months, p<0.05) and group 3 (13.3 per 1000 person-months, p<0.05). A multivariable Cox regression model revealed that age, serum albumin, diabetes mellitus (DM), hypertensive nephropathy, residual renal function and UA group were factors associated with mortality in the PD patients. Using group 2 as a reference, the hazard ratio (HR) of mortality was found to be 1.15 (95% confidence interval [CI] 0.20-2.57, p>0.05) for group 1 and 2.96 (95% CI 1.29-6.80, p=0.01) for group 3.

CONCLUSIONS

In PD patients, a higher serum UA level is related to increased mortality and is an independent risk factor for all-cause mortality. Uric acid levels and all-cause mortality in peritoneal dialysis patients.