Association of Hyperuricemia with Renal Outcomes, Cardiovascular Disease, and Mortality
Association of Hyperuricemia with Renal Outcomes, Cardiovascular Disease, and Mortality
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DOI：
10.2215/cjn.09420911
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发表时间：
2012-04-01
影响因子：
9.8
通讯作者：
Chen, Hung-Chun
中科院分区：
文献类型：
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作者：
Liu, Wan-Chun;Hung, Chi-Chih;Chen, Hung-Chun
背景和目的在普通人群中，高尿酸血症是死亡率、心血管疾病和肾脏疾病的独立危险因素。然而，高尿酸血症与慢性肾脏病临床转归之间的关系仍然存在争议。设计、设置、参与者和测量：本研究调查了3303例CKD患者中尿酸与全因死亡率、心血管事件、肾脏替代治疗和肾脏快速进展(估计的GFR斜率小于-6毫升/分钟/1.73米(2)/年)之间的关系，这些患者在台湾南部的一个医学中心和一家地区医院的综合CKD护理系统中。在平均2.8年的随访期中，有471人(14.3%)死亡，545人(16.5%)心血管事件，1080人(32.3%)开始肾脏替代治疗，841人(25.5%)肾脏进展迅速。高尿酸血症增加了全因死亡率和心血管事件的风险(调整后的四分位数尿酸风险比分别为1.85[1.40-2.44]和1.42[1.08-1.86]，但不增加肾脏替代治疗(0.96[0.79-1.16])和肾脏快速进展(1.30[0.98-1.73])的风险。结论在3-5CKD期，高尿酸血症是全因死亡率和心血管事件的危险因素，但不是肾脏替代治疗和肾脏快速进展的危险因素。临床J am Soc肾病7：541-548,2012。DOI：10.2215/CJN.09420911
Background and objectives Hyperuricemia is an independent risk factor for mortality, cardiovascular disease, and renal disease in general population. However, the relationship between hyperuricemia with clinical outcomes in CKD remains controversial.Design, setting, participants, & measurements The study investigated the association between uric acid with all-cause mortality, cardiovascular events, renal replacement therapy, and rapid renal progression (the slope of estimated GFR was less than -6 ml/min per 1.73 m(2)/y) in 3303 stages 3-5 CKD patients that were in the integrated CKD care system in one medical center and one regional hospital in southern Taiwan.Results In all subjects, the mean uric acid level was 7.9 +/- 2.0 mg/dl. During a median 2.8-year follow-up, there were 471 (14.3%) deaths, 545 (16.5%) cardiovascular events, 1080 (32.3%) participants commencing renal replacement therapy, and 841 (25.5%) participants with rapid renal progression. Hyperuricemia increased risks for all-cause mortality and cardiovascular events (the adjusted hazard ratios for quartile four versus quartile one of uric acid [95% confidence interval] were 1.85 [1.40-2.44] and 1.42 [1.08-1.86], respectively) but not risks for renal replacement therapy (0.96 [0.79-1.16]) and rapid renal progression (1.30 [0.98-1.73]).Conclusions In stages 3-5 CKD, hyperuricemia is a risk factor for all-cause mortality and cardiovascular events but not renal replacement therapy and rapid renal progression. Clin J Am Soc Nephrol 7: 541-548, 2012. doi: 10.2215/CJN.09420911