Key result
Higher serum uric acid levels were independently associated with an increased risk of left ventricular hypertrophy (OR 1.40) and left ventricular diastolic dysfunction (OR 1.93) in patients with pre-dialysis chronic kidney disease.
Why the study?
Serum uric acid has been associated with LVH and LVDD, but this association remains unclear in patients with chronic kidney disease.
Are serum uric acid levels associated with left ventricular hypertrophy and diastolic dysfunction in patients with pre-dialysis chronic kidney disease?
Cross-Sectional (n=1,025)
No
Are serum uric acid levels associated with left ventricular hypertrophy and diastolic dysfunction in patients with pre-dialysis chronic kidney disease?
Odds Ratio: 1.4 (95% CI 1.31–1.5)
p-value: p=<0.001
Elevated serum uric acid levels are independently associated with left ventricular hypertrophy and diastolic dysfunction in patients with pre-dialysis chronic kidney disease, suggesting its potential utility as a biomarker for cardiac structural and functional abnormalities in this population.
Should not yet change practice in pre-dialysis CKD; leaves open whether uric acid drives LV remodeling.
BACKGROUND: The level of serum uric acid (SUA) has been reported to be associated with left ventricular hypertrophy (LVH) and left ventricular diastolic dysfunction (LVDD). However, this association remains unclear in patients with chronic kidney disease (CKD). METHODS: A total of 1025 patients with pre-dialysis CKD with preserved left ventricular systolic function were enrolled in this cross-sectional study. The LVH and LVDD were assessed using two-dimensional echocardiography and tissue Doppler imaging. The associations of LVH/LVDD with clinical and laboratory variables were investigated using univariable and multivariable logistic regression analyses. RESULTS: In a multivariable analysis, the SUA level was an independent predictor of LVH (odds ratio [OR]: 1.40, 95% confidence interval [CI]: 1.31-1.50, P < 0.001). In addition, patient age, systolic blood pressure, intact parathyroid hormone levels, and left atrial volume index levels were independent predictors of LVH. The SUA level was also an independent predictor of LVDD (OR: 1.93, 95% CI: 1.53-2.43, P < 0.001). Furthermore, systolic blood pressure and left atrial volume index levels were an independent predictor of LVDD. Receiver-operating characteristic curve analysis showed that the best cutoff values of SUA levels for identifying LVH and LVDD were ≥ 7.5 mg/dL and ≥ 6.3 mg/dL, respectively. CONCLUSION: The SUA level was an independent predictor of LVD and LVDD in patients with CKD, suggesting that SUA could be a biomarker for LVH and LVDD.
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Kim et al. (2021) conducted a cross-sectional in Pre-dialysis chronic kidney disease (CKD) with preserved left ventricular systolic function (n=1,025). Serum uric acid (SUA) level vs. Lower SUA levels was evaluated on Presence of left ventricular hypertrophy (LVH) (OR 1.40, 95% CI 1.31-1.50, p=<0.001). Higher serum uric acid levels were independently associated with an increased risk of left ventricular hypertrophy (OR 1.40) and left ventricular diastolic dysfunction (OR 1.93) in patients with pre-dialysis chronic kidney disease.