Association of serum uric acid level with coronary artery stenosis severity in Korean end-stage renal disease patients.
Association of serum uric acid level with coronary artery stenosis severity in Korean end-stage renal disease patients.
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DOI：
10.23876/j.krcp.2017.36.3.282
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发表时间：
2017-09
影响因子：
3
通讯作者：
Lee SY
中科院分区：
文献类型：
--
作者：
Jeong HY;Cho HJ;Kim SH;Kim JC;Lee MJ;Yang DH;Lee SY
高尿酸血症在终末期肾病(ESRD)患者中很常见，许多先前的研究报道了高尿酸血症与心血管不良结局之间的关系，这是此类患者死亡的主要原因。探讨终末期肾病维持性血液透析(MHD)患者血尿酸水平与冠状动脉狭窄程度的关系。在721名开始接受MHD治疗的患者中，102人接受了冠状动脉造影检查，抱怨在开始MHD时新出现的胸部不适。我们收集了尿酸水平和冠状动脉管腔直径的数据，将任何主要冠状动脉的管腔直径狭窄超过50%定义为临界狭窄。我们在52例(57.8%)患者中发现了严重的冠状动脉狭窄。平均尿酸水平为(6.6±2.2)mg/dL，临界狭窄组尿酸水平(4.9±1.4)mg/dL显著高于对照组(7.8±2.0)mg/dL(P<0.001)。在多因素分析中，临界狭窄的唯一独立预测因素是血尿酸水平(P<；0.001)。高血尿酸与韩国终末期肾病患者冠状动脉严重狭窄相关。高尿酸血症是一个容易改变的因素，适当地预防它可以为终末期肾病患者带来显著的好处。
Hyperuricemia is common in end-stage renal disease (ESRD) patients, and many previous studies have reported the associations between hyperuricemia and adverse cardiovascular outcomes, which are the major cause of death in such patients. We investigated the relationship between serum uric acid level and the severity of coronary stenosis in ESRD patients on maintenance hemodialysis (MHD). Among 721 patients who started MHD treatment, 102 underwent coronary angiographic tests complaining of chest discomfort that was new at initiation of MHD. We collected data on uric acid level and coronary artery luminal diameter, defining luminal diameter narrowing of more than 50% in any major coronary artery as critical-stenosis. We detected critical coronary artery stenosis in 52 (57.8%) patients. The mean uric acid level was 6.6 ± 2.2 mg/dL, and that was significantly higher in the critical-stenosis group (4.9 ± 1.4 mg/dL vs. 7.8 ± 2.0 mg/dL, P < 0.001). The only independent predictor of critical-stenosis in multivariate analysis was serum uric acid level (P < 0.001). High serum uric acid was associated with severe coronary artery stenosis in Korean ESRD patients. Hyperuricemia is a readily modifiable factor, and appropriately preventing it could provide significant benefits in ESRD patients.