Evaluating the Association of Hyperuricemia in End-Stage Renal Disease Patients on Hemodialysis at a Tertiary Care Hospital

Objective: To highlight the association of hyperuricemia in patients of Chronic Kidney Disease stage 5 on Hemodialysis (CKD-5D) at a tertiary care hospital. Study Design: Cross-sectional study. Place and Duration of Study: Department of Nephrology and Dialysis Unit, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jul to Dec 2021. Methodology: Using a consecutive sampling technique, CKD patients of either gender with age >15 years, both dialysis dependent (CKD-5D) and non-dialysis dependent (CKD-5ND), were included and divided into two groups of 80 each. Serum uric acid levels of both groups (CKD-5ND and CKD-5D) patients were assessed and analyzed. Measures of association odds ratio and the prevalence ratio, were calculated. Results: The mean age was 53.76±18.26 years in Group-A (CKD-5ND) and 52.46±17.50 years in Group-B (CKD-5D) (p=0.667). Out of the total 80 CKD-5D patients in Group-B, 14(17.5%) underwent HD once weekly, 37(46.3%) twice weekly, and 29(36.3%) undergoing hemodialysis thrice weekly. CKD-5ND patients tend to have higher levels of uric acid as compared to CKD-5D patients, 51(63.8%) vs 33(41.3%), respectively (p=0.004). Patients undergoing once weekly hemodialysis had higher levels of uric acid, 9(27.3%), and patients undergoing twice or thrice weekly hemodialysis, 17(51.5%) and 7(21.2%), had hyperuricemia, respectively (p=0.032). Conclusion. There is a high prevalence of hyperuricemia in CKD patients, and with declining eGFR, uric acid levels increase. Patients undergoing thrice weekly maintenance hemodialysis had a lower prevalence of raised uric acid levels with once weekly hemodialysis and CKD patients without hemodialysis.