title: Relationship between serum uric acid and all-cause and cardiovascular mortality in patients treated with peritoneal dialysis.
abstract: BACKGROUND
  Although serum uric acid level appears to be associated with mortality in individuals treated with hemodialysis, the relationship between serum uric acid level and death is uncertain in patients treated with peritoneal dialysis (PD).
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  985 patients from a single PD center in South China followed up for a median of 25.3 months.
  
  
  METHODS
  Serum uric acid level.
  
  
  METHODS
  The association of baseline sex-specific uric acid level with all-cause and cardiovascular mortality was evaluated. Models were adjusted for age, body mass index, comorbidity score, residual kidney function, total Kt/V, allopurinol and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use, and laboratory test results, including hemoglobin, serum albumin, creatinine, calcium, phosphorus, triglycerides, low-density lipoprotein cholesterol, and high-sensitivity C-reactive protein.
  
  
  RESULTS
  Mean age was 48.3±15.4 (SD) years, and 23% had diabetes. Mean uric acid level was 7.0±1.3 (range, 3.8-19.8) mg/dL. During follow-up, 144 deaths were recorded, of which 64 were due to cardiovascular events. In multivariable models, the highest sex-specific tertile of uric acid level was associated with increased risk of all-cause mortality (HR, 1.93; 95% CI, 1.27-2.93; P=0.004) and cardiovascular mortality (HR, 3.31; 95% CI, 1.70-6.41; P<0.001) compared to the lowest tertile. Adjusted Cox regression models showed that the HRs per 1-mg/dL higher uric acid level for all-cause and cardiovascular mortality were 1.33 (95% CI, 1.14-1.56; P<0.001) and 1.44 (95% CI, 1.17-1.77; P=0.001) for men and 1.03 (95% CI, 0.86-1.24; P=0.8) and 1.16 (95% CI, 0.97-1.38; P=0.1) for women, respectively. A formal test for interaction indicated that the association of uric acid level with all-cause and cardiovascular mortality differed by sex (β = -0.06 [P=0.02] and β = -0.10 [P=0.02], respectively).
  
  
  CONCLUSIONS
  Single measurement of uric acid at baseline. Cause of death determined by death certificates and expert consensus.
  
  
  CONCLUSIONS
  Elevated serum uric acid level is an independent risk factor for all-cause and cardiovascular mortality in men treated with PD.
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Xia
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Feng
authors.initials: F
authors.lastname: He
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Xianfeng
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Fenfen
authors.initials: F
authors.lastname: Peng
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. Electronic address: hfxyl@163.net.
authors.forename: Fengxian
authors.initials: F
authors.lastname: Huang
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. Electronic address: yuxq@mail.sysu.edu.cn.
authors.forename: Xueqing
authors.initials: X
authors.lastname: Yu
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033461:Hyperuricemia / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D010530:Peritoneal Dialysis / Q000401:mortality* / Q000639:trends; D011446:Prospective Studies; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid
keywords: Serum uric acid; all-cause mortality; cardiovascular mortality; peritoneal dialysis