title: U-shaped relationship between uric acid and residual renal function decline in continuous ambulatory peritoneal dialysis patients.
abstract: OBJECTIVE
  There is little information on the relationship between uric acid (UA) and residual renal function (RRF) in continuous ambulatory peritoneal dialysis (CAPD). The aim of this research is to study the influence of UA on RRF decline in CAPD patients.
  
  
  METHODS
  A retrospective observational cohort study of 304 patients who started CAPD without anuria between 2001 and 2010 was conducted at a single medical center. The outcomes measured in the study included the rate of RRF decline and anuria. A multiple ordinal logistic regression model with backward elimination was conducted to determine the independent factors of the slope of RRF decline. A Cox proportional hazard model was conducted to determine the independent variables of time to anuria.
  
  
  RESULTS
  The average rate of RRF decline was -0.12 ± 0.22 mL/min per month. Multivariate analysis showed that lower UA group (<0.372 mmol/L), higher UA group (≧0.421 mmol/L), male gender, diabetes mellitus (DM), the use of calcium channel blocker (CCB), and RRF at baseline were linked positively with the rate of RRF decline; on the other hand, independence in dialysate exchanges and BUN were negatively associated with the risk of RRF decline. In addition, male gender, DM, diuretics, and CCB were associated with a higher risk of progression to anuria, whereas 24-h urine amount at baseline conferred a protective role in the development of anuria.
  
  
  CONCLUSIONS
  A U-shaped relationship was found between UA levels and the rate of RRF decline in patients on CAPD, with a faster decline rate in those of higher and lower UA groups.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.|Ph.D. program in Translational Medicine, College of Life Science, National Chung Hsing University, Taichung, Taiwan.|School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Yao-Peng
authors.initials: YP
authors.lastname: Hsieh
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Chia-Chu
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Chew-Teng
authors.initials: CT
authors.lastname: Kor
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Yao-Ko
authors.initials: YK
authors.lastname: Wen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Ping-Fang
authors.initials: PF
authors.lastname: Chiu
authors.affiliation: Institute of Biomedical Sciences, College of Life Science, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Chi-Chen
authors.initials: CC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D001002:Anuria / Q000209:etiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000503:physiopathology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010531:Peritoneal Dialysis, Continuous Ambulatory; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid
keywords: continuous ambulatory peritoneal dialysis; end stage renal disease; residual renal function; time to anuria; uric acid