ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: SA-PO362

GFR-Adjusted Uric Acid Is Superior in Prediction of All-Cause Mortality Compared with Uric Acid or Uric Acid/Serum Creatinine

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical

Authors

  • Koenigshausen, Eva, Heinrich-Heine-Universitat Dusseldorf, Dusseldorf, Nordrhein-Westfalen, Germany
  • Rump, Lars C., Heinrich-Heine-Universitat Dusseldorf, Dusseldorf, Nordrhein-Westfalen, Germany
  • Sellin, Lorenz, Heinrich-Heine-Universitat Dusseldorf, Dusseldorf, Nordrhein-Westfalen, Germany
Background

Elevated uric acid (UA) levels and serum UA to serum creatinine ratio (sUA/sCr) are associated with increased cardiovascular risk. We investigated GFR, age and sex-adjusted UA levels (eUA) to further increase precision in cardiovascular risk prediction.

Methods

The eUA formula was validated in the LURIC cohort. Due to GFR restrictions, a subpopulation of 2654 patients was evaluated. Outcome variables (mortality, cardiovascular events, heart failure NYHA > II) were analyzed in a risk group (eUA < UA) compared to the control group (eUA > UA). Uni- and multivariate regression analysis was performed for known risk factors as well as UA, eUA and sUA/sCr.

Results

eUA levels were calculated on the basis of the presented eUA formula. Mortality (OR 1.35; 95 % CI 1.09 -1.67; p = 0.006) and heart failure NYHA > II (OR 1.91; 95 % CI 1.53 – 2.39; p < 0.001) were significantly increased in patients within the risk group (eUA < UA). Multivariate analysis revealed a better prediction of mortality with eUA (OR 7.41; 95 % CI 3.15 -17.47; p<0.001) compared to sUA/sCr (OR 1.12; 95 % CI 1.05 – 1.19; p < 0.001) or UA (OR 1.09; 95 % CI 1.02 – 1.16; p = 0.006) after adjustment for known cardiovascular risk factors. Cardiac events or heart failure NYHA > II was statistically not associated with eUA levels.

Conclusion

Assessment of the newly calculated eUA identifies patients with a particularly increased cardiovascular risk. eUA is superior in predicting mortality compared to established markers such as UA or sUA/sCr.