Correlation Between Hyperuricemia And Cardiovascular Events In Hemodialysis Patients With End-stage Renal Disease

[Background]With the change of life and production mode and the influence of various diseases,the incidence of chronic kidney disease(CKD)is increasing year by year,which is a major global health burden.End-stage renal disease(ESRD)is the final outcome of chronic kidney disease.Most patients with end-stage renal disease choose hemodialysis as the maintenance treatment.According to relevant studies,cardiovascular events are the most important cause of death for hemodialysis patients.Many studies have shown that hyperuricmia is an independent risk factor for cardiovascular events.Some studies also believe that the lower the level of uric acid,the lower the probability of cardiovascular events.The effect of high uric acid on cardiovascular events remains controversial.Hyperuricemia is common in hemodialysis patients with end-stage renal disease,and there are few studies on the effect of hyperuricemia on cardiovascular disease in hemodialysis patients with end-stage renal disease.Therefore,whether hyperuricemia can be used as a factor affecting cardiovascular events in hemodialysis patients with end-stage renal disease is worth further investigation.[Objective]To explore the correlation between hyperuricemia and cardiovascular events in hemodialysis patients with end-stage renal disease,and to provide a new predictive index for the occurrence of cardiovascular events in hemodialysis patients with end-stage renal disease.[Methods]Based on the inclusion criteria and exclusion criteria,160 patients with end-stage renal disease who were regularly dialyzed in the blood purification center of the second hospital of shandong university from June 2017 to January 2019 were selected,including 104 male patients and 56 female patients,aged between 25 and 78 years old,with an average age of 51.7 years.Sort out patients’ basic information and basic laboratory tests data,the uric acid level>420umol/L(male),uric acid level>360umol/L(female)for high uric acid group,the levels of uric acid in the normal range(male<420umol/L,female<360umol/L)into the group of patients as control group,the myocardial ischemia and heart failure as observation index of cardiovascular events,There were 82 patients in the hyperuricemia group,including 67 patients with myocardial ischemia,40 patients with heart failure and 25 patients with myocardial ischemia complicated with heart failure.There were 78 patients in the control group,including 10 patients with myocardial ischemia,13 patients with heart failure,and 6 patients with myocardial ischemia complicated with heart failure.SPSS(SPSS 18.)was used for statistical analysis of all the data.Rank-sum test was used to compare the basic laboratory indexes of the two groups,and binary Logistic regression analysis was performed.P<0.05 was considered statistically significant.To evaluate whether uric acid is an independent risk factor for cardiovascular events in hemodialysis patients with end-stage renal disease.[Results]Compared with the hemodialysis patients in the high uric acid group and the control group,age of hemodialysis,albumin,urea nitrogen,creatinine,BNP,troponin,myoglobin,creatine kinase isoenzyme,D-dimer patients were higher than control group,and group of hemodialysis patients with hyperuricmia water of taken off,hemoglobin,HDL cholesterol and ejection fraction were lower than control group in hemodialysis patients,differences between the two groups have statistical significance(P<0.05),It is suggested that age of hemodialysis,albumin,urea nitrogen,creatinine,BNP,troponin,myoglobin,creatine kinase isozyme,d-dimer,dehydration,hemoglobin,high-density cholesterol and ejection fraction are correlated with the occurrence of high uric acid.Gender,age,smoking or not,alcohol consumption,history of hypertension,history of heart disease,c-reactive protein,microglobulin,cystatin,CO 2 binding force,total cholesterol,triglyceride,low density cholesterol,calcium,phosphorus,potassium,parathyroid hormone between the two groups had no statistical difference(P>0.05).Logistic regression analysis showed that serum uric acid was an independent risk factor for cardiovascular events in patients with end-stage renal disease,as well as for myocardial ischemia and heart failure.[Conclusion]Serum uric acid is involved in the occurrence of cardiovascular events in hemodialysis patients with end-stage renal disease through multiple mechanisms.Hyperuricemia is an independent risk factor for cardiovascular events in hemodialysis patients with end-stage renal disease.The detection and timely intervention of uric acid level can effectively prevent the occurrence of cardiovascular events.