Serum Uric Acid Independently Predicts Cardiovascular Events in Advanced Nephropathy

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dc.contributor.authorKanbay, Mehmet
dc.contributor.authorYilmaz, Mahmut Ilker
dc.contributor.authorSonmez, Alper
dc.contributor.authorSolak, Yalcin
dc.contributor.authorSaglam, Mutlu
dc.contributor.authorCakir, Erdinc
dc.contributor.authorUnal, Hilmi Umut
dc.date.accessioned2024-02-23T14:26:39Z
dc.date.available2024-02-23T14:26:39Z
dc.date.issued2012
dc.departmentNEÜen_US
dc.description.abstractBackground: Chronic kidney disease (CKD) is associated with increased risk for cardiovascular (CV) disease and is also associated with elevated uric acid, which is emerging as a nontraditional CV risk factor. We therefore evaluated uric acid as a risk factor for CV disease in subjects presenting to nephrologists with CKD who were not on medications known to alter endothelial function. Methods: 303 subjects with stage 3-5 CKD were followed for a mean of 39 months (range 6-46) and assessed for fatal and nonfatal CV events. Hyperuricemia was defined as uric acid >6.0 mg/dl for women and >7.0 mg/dl for men. In addition to other CV risk factors, endothelial function (flow-mediated dilatation), inflammatory markers (hsCRP), and insulin resistance (HOMA index and fasting insulin levels) were included in the analysis. We evaluated the association between uric acid and flow-mediated dilatation with linear regression. The impact of uric acid on composite CV events was assessed with Cox regression analysis. Results: Of a total of 303 patients, 89 had normouricemia and 214 had hyperuricemia. Both fatal (32 of 214 vs. 1 of 89 subjects) and combined fatal and nonfatal (100 of 214 vs. 13 of 89 subjects) CV events were more common in subjects with hyperuricemia compared with normal uric acid levels, and this was independent of estimated glomerular filtration rate, traditional CV risk factors including diabetes, hypertension and BMI, and nontraditional risk factors (hsCRP and endothelial function). The 46-month survival rate was 98.7% in the group with low uric acid compared to 85.8% in patients with high uric acid (p = 0.002). Conclusions: Hyperuricemia is an independent risk factor for CV events in subjects presenting with CKD who are not on medications known to alter endothelial function. Copyright (C) 2012 S. Karger AG, Baselen_US
dc.description.sponsorshipNIH/NCRR Colorado CTSI [UL1 RR025780]en_US
dc.description.sponsorshipKim McFann is supported in part by NIH/NCRR Colorado CTSI Grant UL1 RR025780.en_US
dc.identifier.doi10.1159/000342390
dc.identifier.endpage331en_US
dc.identifier.issn0250-8095
dc.identifier.issn1421-9670
dc.identifier.issue4en_US
dc.identifier.pmid23007099en_US
dc.identifier.scopus2-s2.0-84866516012en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage324en_US
dc.identifier.urihttps://doi.org/10.1159/000342390
dc.identifier.urihttps://hdl.handle.net/20.500.12452/14265
dc.identifier.volume36en_US
dc.identifier.wosWOS:000310563900004en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherKargeren_US
dc.relation.ispartofAmerican Journal Of Nephrologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectUric Aciden_US
dc.subjectChronic Kidney Diseaseen_US
dc.subjectCardiovascular Diseaseen_US
dc.titleSerum Uric Acid Independently Predicts Cardiovascular Events in Advanced Nephropathyen_US
dc.typeArticleen_US

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