Serum Uric acid level as an estimated parameter predicts all-cause mortality in patients with hemodialysis

Abstract Background: Serum uric acid (UA) level in end stage renal disease (ESRD) patients is an important physiological index for nutrition and inflammation. Serum UA displays a U-shape associated with all-cause mortality in ESRD patients. In this study, we evaluated relevance of serum UA level with survival rate in ESRD patients according to Charlson comorbidity index (CCI). Methods: Our cohort of2615 subjects suffer from ESRD with CCI < 4 and ≥ 4. Of the 2615 subjects, 1107 subjects are CCI < 4 and others are CCI ≥ 4. The two independent groups were individually marked by serum UA sextiles. Results: With Cox regression, serum UA levels higher than 8.6 mg/dl in the ESRD with CCI < 4 denoted as risk factor for all-cause mortality (hazard ratio (HR): 1.61, 95% CI: 1.01–2.38), compared to these subjects with UA of 7.1-7.7 mg/dl. In contrast, serum UA levels < 5.8 mg/dl represent risk factor for all-cause mortality in subjects with CCI ≥ 4 (HR: 1.53, 95% CI: 1.20–1.95) compared with UA > 8.6 mg/dl. Conclusion: Higher serum UA in ESRD subjects with high comorbidities is hardly a risk factor. Profoundly, low UA should be prevented in all ESRD patients.