Association of hyperuricemia and serum uric acid lowering therapy with mortality in hemodialysis patients
Introduction In the general population, hyperuricemia is associated with increased morbidity and mortality. Data on this association in hemodialysis patients is controversial. Moreover, it remains elusive whether serum uric acid (SUA) lowering therapy is associated with mortality. Methods Retrospect...
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doaj-0de4416041ef4703a49d584ed40ab5bd2021-03-18T14:42:07ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492020-01-014211067107510.1080/0886022X.2020.18356741835674Association of hyperuricemia and serum uric acid lowering therapy with mortality in hemodialysis patientsBenjamin Rohn0Wiebke Jansing1Felix S. Seibert2Thiemo Pfab3Okan Cinkilic4Jürgen Paßfall5Sven Schmidt6Nina Babel7Frederic Bauer8Timm H. Westhoff9Medical Department I, Universitätsklinikum Marien Hospital Herne, Ruhr-UniversityMedical Department I, Universitätsklinikum Marien Hospital Herne, Ruhr-UniversityMedical Department I, Universitätsklinikum Marien Hospital Herne, Ruhr-UniversityMVZ Diaverum PotsdamDialysezentrum SchwerteNierenzentrum CharlottenburgDialysezentrumMedical Department I, Universitätsklinikum Marien Hospital Herne, Ruhr-UniversityMedical Department I, Universitätsklinikum Marien Hospital Herne, Ruhr-UniversityMedical Department I, Universitätsklinikum Marien Hospital Herne, Ruhr-UniversityIntroduction In the general population, hyperuricemia is associated with increased morbidity and mortality. Data on this association in hemodialysis patients is controversial. Moreover, it remains elusive whether serum uric acid (SUA) lowering therapy is associated with mortality. Methods Retrospective analysis of 601 patients on chronic hemodialysis therapy in five outpatient centers with a maximum follow-up of 100 and a mean follow-up of 41 months. Death was defined as primary endpoint. Cumulative survival was analyzed by Kaplan–Meier analysis and Cox regressions adjusted for age. Findings Cumulative survival rates were higher for those subjects with a higher than median SUA concentration both based on mean annual and baseline measurements (p < 0.05 each). There was no survival difference anymore after adjustment for age (p > 0.05 each). Stratification for SUA lowering therapy (allopurinol/febuxostat) had no impact on cumulative survival, neither in Kaplan Meier nor in Cox regression analyses (p > 0.05 each). Furthermore, Cox regression analysis excluded an increased cardiovascular mortality in subjects with hyperuricemia. Discussion In contrast to the general population, hyperuricemia is not associated with increased mortality in patients undergoing hemodialysis. Moreover, xanthine oxidase inhibition was not associated with a survival benefit in this analysis. These data do not support the use of SUA lowering medication in hemodialysis patients with asymptomatic hyperuricemia.http://dx.doi.org/10.1080/0886022X.2020.1835674chronic kidney diseasehyperuricemiahemodialysismortalitygout |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Benjamin Rohn Wiebke Jansing Felix S. Seibert Thiemo Pfab Okan Cinkilic Jürgen Paßfall Sven Schmidt Nina Babel Frederic Bauer Timm H. Westhoff |
spellingShingle |
Benjamin Rohn Wiebke Jansing Felix S. Seibert Thiemo Pfab Okan Cinkilic Jürgen Paßfall Sven Schmidt Nina Babel Frederic Bauer Timm H. Westhoff Association of hyperuricemia and serum uric acid lowering therapy with mortality in hemodialysis patients Renal Failure chronic kidney disease hyperuricemia hemodialysis mortality gout |
author_facet |
Benjamin Rohn Wiebke Jansing Felix S. Seibert Thiemo Pfab Okan Cinkilic Jürgen Paßfall Sven Schmidt Nina Babel Frederic Bauer Timm H. Westhoff |
author_sort |
Benjamin Rohn |
title |
Association of hyperuricemia and serum uric acid lowering therapy with mortality in hemodialysis patients |
title_short |
Association of hyperuricemia and serum uric acid lowering therapy with mortality in hemodialysis patients |
title_full |
Association of hyperuricemia and serum uric acid lowering therapy with mortality in hemodialysis patients |
title_fullStr |
Association of hyperuricemia and serum uric acid lowering therapy with mortality in hemodialysis patients |
title_full_unstemmed |
Association of hyperuricemia and serum uric acid lowering therapy with mortality in hemodialysis patients |
title_sort |
association of hyperuricemia and serum uric acid lowering therapy with mortality in hemodialysis patients |
publisher |
Taylor & Francis Group |
series |
Renal Failure |
issn |
0886-022X 1525-6049 |
publishDate |
2020-01-01 |
description |
Introduction In the general population, hyperuricemia is associated with increased morbidity and mortality. Data on this association in hemodialysis patients is controversial. Moreover, it remains elusive whether serum uric acid (SUA) lowering therapy is associated with mortality. Methods Retrospective analysis of 601 patients on chronic hemodialysis therapy in five outpatient centers with a maximum follow-up of 100 and a mean follow-up of 41 months. Death was defined as primary endpoint. Cumulative survival was analyzed by Kaplan–Meier analysis and Cox regressions adjusted for age. Findings Cumulative survival rates were higher for those subjects with a higher than median SUA concentration both based on mean annual and baseline measurements (p < 0.05 each). There was no survival difference anymore after adjustment for age (p > 0.05 each). Stratification for SUA lowering therapy (allopurinol/febuxostat) had no impact on cumulative survival, neither in Kaplan Meier nor in Cox regression analyses (p > 0.05 each). Furthermore, Cox regression analysis excluded an increased cardiovascular mortality in subjects with hyperuricemia. Discussion In contrast to the general population, hyperuricemia is not associated with increased mortality in patients undergoing hemodialysis. Moreover, xanthine oxidase inhibition was not associated with a survival benefit in this analysis. These data do not support the use of SUA lowering medication in hemodialysis patients with asymptomatic hyperuricemia. |
topic |
chronic kidney disease hyperuricemia hemodialysis mortality gout |
url |
http://dx.doi.org/10.1080/0886022X.2020.1835674 |
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