Serum uric acid to creatinine ratio as a risk factor for mortality among patients on continuous ambulatory peritoneal dialysis: a multi-center retrospective study

• Published in: Renal Failure
• Main Authors: 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
• Format: Article
• Language: English
• Published: Taylor & Francis Group 2023-12-01
• Subjects: Continuous ambulatory peritoneal dialysis; serum uric acid; serum creatinine; all-cause mortality; cardiovascular mortality
• Online Access: https://www.tandfonline.com/doi/10.1080/0886022X.2023.2273979
• ISSN: 0886-022X; 1525-6049

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.