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J-Shaped Mortality Relationship for Uric Acid in CKD

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Presentation on theme: "J-Shaped Mortality Relationship for Uric Acid in CKD"— Presentation transcript:

1 J-Shaped Mortality Relationship for Uric Acid in CKD
Mohamed E. Suliman, MD, PhD, Richard J. Johnson, MD, PhD, Elvia García-López, MD, A. Rashid Qureshi, MD, PhD, Hadi Molinaei, MD, Juan Jesús Carrero, PhD, Olof Heimbürger, MD, PhD, Peter Bárány, MD, PhD, Jonas Axelsson, MD, PhD, Bengt Lindholm, MD, PhD, Peter Stenvinkel, MD, PhD  American Journal of Kidney Diseases  Volume 48, Issue 5, Pages (November 2006) DOI: /j.ajkd Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

2 Fig 1 Relationships of serum uric acid levels with HDL cholesterol and apo A levels in 294 patients with CKD starting renal replacement therapy. To convert uric acid in mg/dL to μmol/L, multiply by American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

3 Fig 2 Associations of serum uric acid levels with plasma phosphate (ρ = 0.24; P = 0.001) and Ca × P product values (ρ = 0.21; P = 0.001) in 294 patients with CKD starting renal replacement therapy. After adjustment for phosphate-binder and vitamin D treatment, correlations of uric acid level with phosphate level (ρ = 0.24; P < ) and Ca × P product (ρ = 0.19; P = 0.001) were statistically significant. To convert uric acid in mg/dL to μmol/L, multiply by American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

4 Fig 3 HRs for mortality of patients in each of 5 quintiles of serum uric levels. The middle quintile is the reference (HR = 1). American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

5 Fig 4 (A) Unadjusted and (B) adjusted all-cause mortality in relation to serum uric acid levels in patients with CKD starting renal replacement therapy. Patients were divided into 3 groups based on quintiles of uric acid levels. Group I (low) includes patients in the lower quintile (<5.3 mg/dL [<315 μmol/L]), group II (middle) includes patients in the 3 middle quintiles (5.3 to 8.9 mg/dL [315 to 529 μmol/L]), and group III (high) includes patients in the upper quintiles (>8.9 mg/dL [>529 μmol/L]) of uric acid. (B) Survival was adjusted for age, sex, GFR, cholesterol level, phosphate level, inflammation, CVD, DM, diuretic use, and allopurinol treatment (likelihood ratio, chi-square = 53.2; P < ). American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

6 Fig 5 The J-shaped mortality relationship for uric acid levels in patients with CKD stage 5 starting renal replacement therapy. Compared with the 3 middle quintiles as a reference, HRs were 1.96 (CI, 1.10 to 3.48) for the higher quintile and 1.42 (CI, 0.76 to 2.66) for the lower quintile. The analysis was adjusted for age, sex, GFR, cholesterol level, phosphate level, inflammation, CVD, DM, diuretic use, and allopurinol use. American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions


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