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. 2014 Jan 8;9(1):e82342.
doi: 10.1371/journal.pone.0082342. eCollection 2014.

The associations of uric acid, cardiovascular and all-cause mortality in peritoneal dialysis patients

Jie Dong  1 , Qing-Feng Han  2 , Tong-Ying Zhu  3 , Ye-Ping Ren  4 , Jiang-Hua Chen  5 , Hui-Ping Zhao  6 , Meng-Hua Chen  7 , Rong Xu  1 , Yue Wang  2 , Chuan-Ming Hao  3 , Rui Zhang  4 , Xiao-Hui Zhang  5 , Mei Wang  6 , Na Tian  7 , Hai-Yan Wang  1
Affiliations

The associations of uric acid, cardiovascular and all-cause mortality in peritoneal dialysis patients

Jie Dong et al. PLoS One. .

Abstract

Aims: To investigate whether uric acid (UA) is an independent predictor of cardiovascular (CV) and all-cause mortality in peritoneal dialysis (PD) patients after controlling for recognized CV risk factors.

Methods: A total of 2264 patients on chronic PD were collected from seven centers affiliated with the Socioeconomic Status on the Outcome of Peritoneal Dialysis (SSOP) Study. All demographic and laboratory data were recorded at baseline. Multivariate Cox regression was used to calculate the hazard ratio (HR) of CV and all-cause mortality with adjustments for recognized traditional and uremia-related CV factors.

Results: There were no significant differences in baseline characteristics between patients with (n = 2193) and without (n = 71) UA measured. Each 1 mg/dL of increase in UA was associated with higher all-cause mortality with 1.05(1.00∼1.10) of HR and higher CV mortality with 1.12 (1.05∼1.20) of HR after adjusting for age, gender and center size. The highest gender-specific tertile of UA predicted higher all-cause mortality with 1.23(1.00∼1.52) of HR and higher CV mortality with 1.69 (1.21∼2.38) of HR after adjusting for age, gender and center size. The predictive value of UA was stronger in patients younger than 65 years without CV disease or diabetes at baseline. The prognostic value of UA as both continuous and categorical variable weakened or disappeared after further adjusted for uremia-related and traditional CV risk factors.

Conclusions: The prognostic value of UA in CV and all-cause mortality was weak in PD patients generally, which was confounded by uremia-related and traditional CV risk factors.

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Conflict of interest statement

Competing Interests: This study was partly funded by Baxter Corp and there are no patents, products in development or marketed products to declare. This does not alter adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Figures

Figure 1
Figure 1. The distribution chart of serum uric acid.
Figure 2
Figure 2. Risk of CVD mortality in all subjects and subgroups.
Subgroups were divided by age ≥65 years or <65 years, with or without CVD or DM at baseline. All models are adjusted for age, gender and center size. Abbreviations: UA, uric acid; CDV, cardiovascular disease; DM, diabetes.
Figure 3
Figure 3. Risk of all-cause mortality in all subjects and subgroups.
Subgroups were divided by age ≥65 years or <65 years, with or without CVD or DM at baseline. All models are adjusted for age, gender and center size. Abbreviations: UA, uric acid; CDV, cardiovascular disease; DM, diabetes.
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