Serum uric acid to creatinine ratio as a risk factor for mortality among patients on continuous ambulatory peritoneal dialysis: a multi-center retrospective study
Jieping Hu,
Liwen Tang,
Xiaojiang Zhan,
Fenfen Peng,
Xiaoyang Wang,
Yueqiang Wen,
Xiaoran Feng,
Xianfeng Wu,
Xingcui Gao,
Qian Zhou,
Wei Zheng,
Ning Su,
Xingming Tang
Affiliations
Jieping Hu
Department of Nephrology, Dongguan Tungwah Hospital, Dongguan, China
Liwen Tang
Department of Nephrology, Dongguan Songshan Lake Tungwah Hospital, Dongguan, China
Xiaojiang Zhan
Department of Nephrology, The First Affiliated Hospital, Nanchang University, Nanchang, China
Fenfen Peng
Department of Nephrology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
Xiaoyang Wang
Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
Yueqiang Wen
Department of Nephrology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
Xiaoran Feng
Department of Nephrology, Jiujiang No. 1 People’s Hospital, Jiujiang, China
Xianfeng Wu
Department of Nephrology, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, China
Xingcui Gao
Department of Cardiology, Dongguan Songshan Lake Tungwah Hospital, Dongguan, China
Qian Zhou
Department of Medical Statistics, Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Wei Zheng
Department of Nephrology, Dongguan Songshan Lake Tungwah Hospital, Dongguan, China
Ning Su
Department of Hematology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Xingming Tang
Department of Nephrology, Dongguan Songshan Lake Tungwah Hospital, Dongguan, China
Background Serum uric acid to serum creatinine ratio (SUA/Scr) has emerged as a new biomarker, which is significantly associated with several metabolic diseases. However, no study has investigated the association between SUA/Scr and mortality among patients on continuous ambulatory peritoneal dialysis (CAPD).Methods In this multicenter retrospective cohort study, we enrolled CAPD patients in eight tertiary hospitals in China from 1 January 2005 to 31 May 2021. Cox proportional hazard models were used to determine the relationship between SUA/Scr and mortality.Results A total of 2480 patients were included; the mean age was 48.9 ± 13.9 years and 56.2% were males. During 12648.0 person-years of follow-up, 527 (21.3%) patients died, of which 267 (50.7%) deaths were caused by cardiovascular disease. After multivariable adjustment for covariates, per unit increase in SUA/Scr was associated with a 62.9% (HR, 1.629 (95% confidence interval (CI) 1.420–1.867)) and 73.0% (HR, 1.730 (95% CI 1.467–2.041)) higher risk of all-cause and cardiovascular mortality. Results were similar when categorized individuals by SUA/Scr quartiles. Compared with the lowest quartile of SUA/Scr, the highest and the second highest quartile of SUA/Scr had a 2.361-fold (95% CI 1.810–3.080) and 1.325-fold (95% CI 1.003–1.749) higher risk of all-cause mortality, as well as a 3.701-fold (95% CI 2.496–5.489) and 2.074-fold (95% CI 1.387–3.100) higher risk of cardiovascular mortality. Multivariable-adjusted spline regression models showed nonlinear association of SUA/Scr with mortality in CAPD patients.Conclusions Higher levels of SUA/Scr were associated with higher risk of all-cause and cardiovascular mortality in CAPD patients.
