Elevated serum uric acid and risk of cardiovascular or all-cause mortality in maintenance hemodialysis patients: A meta-analysis.
BACKGROUND AND AIMS
Studies have shown inconsistent results about the association between serum uric acid (SUA) levels and mortality in hemodialysis patients. We performed this meta-analysis to determine whether higher SUA values comprised a risk factor of cardiovascular or all-cause mortality in maintenance hemodialysis patients.


METHODS AND RESULTS
Pubmed, Embase and the Cochrane library were searched up to August 31, 2020 for the longitudinal studies that investigated the association between the elevated SUA and cardiovascular or all-cause mortality risk in maintenance hemodialysis patients. Pooled adjusted hazard ratios (HR) and corresponding 95% confidence interval (CI) were calculated using a random-effects model. We included 10 studies with an overall sample of 264,571 patients with hemodialysis in this meta-analysis. Patients with the highest SUA were associated with a decreased risk of cardiovascular mortality (HR = 0.72, 95% CI 0.59-0.87) compared with patients with the lowest SUA after adjustment for potential confounders in a random effects model. Moreover, for each increase of 1 mg/dl of SUA, the overall risks of all-cause and cardiovascular mortality decreased by 6% and 9%, respectively (HR = 0.94, 95% CI 0.90-0.99; HR = 0.91, 95% CI 0.89-0.94).


CONCLUSION
Elevated SUA levels are strongly and independently associated with lower risk of cardiovascular mortality in maintenance hemodialysis patients. More designed studies, especially randomized controlled trials, should be conducted to determine whether high SUA levels is an independent risk factor of all-cause mortality in hemodialysis patients.
['Wang|Huifang|H|', 'Liu|Jun|J|', 'Xie|Demin|D|', 'Liu|Hang|H|', 'Zhen|Li|L|', 'Guo|Dandan|D|', 'Liu|Xuemei|X|']
D000328:Adult D000368:Aged D015415:Biomarkers D002423:Cause of Death D005260:Female D000082742:Heart Disease Risk Factors D006801:Humans D033461:Hyperuricemia D007674:Kidney Diseases D008297:Male D008875:Middle Aged D064887:Observational Studies as Topic D011379:Prognosis D006435:Renal Dialysis D018570:Risk Assessment D013997:Time Factors D015854:Up-Regulation D014527:Uric Acid
Serum uric acid All-cause mortality Hemodialysis Meta-analysis Cardiovascular mortality