Correlation Between Hyperuricemia And Cardiovascular Risk Factors In Maintenance Hemodialysis Patients

Objective: To investigate the incidence of hyperuricemia(HUA)in maintenance hemodialysis patients(MHD)and its relationship with cardiovascular risk factors,and to provide a theoretical basis and clinical guidance for the prevention and treatment of cardiovascular-related complications in maintenance hemodialysis patients.Methods: 1.From September 2017 to September 2018,122 maintenance hemodialysis patients in Blood Purification Center of Affiliated Chinese Medicine Hospital of Southwest Medical University were enrolled.During the observation period,8 patients died,15 patients with uric acid fluctuations were excluded,and 99 patients were finally included in the study.The patient's gender,age,dialysis age,primary disease leading to renal failure,smoking,drinking,exercise,etc.were counted.Blood pressure,height,weight,abdominal fat thickness,waist circumference and fasting venous blood samples were collected on the first day of dialysis.The UA,hs-CRP,ALB,TG,TC,LDL,HDL,Hcy,Ca,P,and PTH were detected in our laboratory testing center.After dialysis,echocardiography was performed to determine LVPW,IVSd,LVEDD,LVESD,and LVEF.2.To analyze the correlation between the blood uric acid levels and cardiovascular risk factors.Results: 1.This study included 99 people,of whom 19 were normouricemicand 80 were hyperuricemic.The prevalence of HUA was 80.9%.2.During the period,8 people died,of whom 7 people were HUA,and 1 person had normal uric acid.The incidence of HUA was 87.5%,of which 6 people died of heart and cerebrovascular events,and the proportion of cardiovascular and cerebrovascular events was 75%.3.Heavy smoking,heavy drinking,lack of exercise,abdominal obesity,and elevated systolic blood pressure were all closely related to elevated blood uric acid(P<0.05).Logistic regression analysis showed that heavy smoking(OR=2.500,95% CI: 1.760,8.219,P=0.013),heavy drinking(OR=1.146,95% CI: 0.171,0.951,P=0.021),abdominal fat increased(OR=0.498,95% CI: 1.073,1.225,P<0.001),waist circumference increase(OR=1.177,95% CI: 1.087,1.274,P<0.001),systolic blood pressure increased(OR=1.123,95% CI: 1.063,1.185,P < 0.001)may increase the risk of hyperuricemia.4.TG,TC,CRP,PTH and Hcy were higher in the group with elevated blood uric acid than that in the normal uric acid group(P<0.05),and HDL was lower than the normal uric acid group(P<0.05);After further stratification grouping by uric acid level,it was found that with the gradual increase of uric acid level,TG,TC,CRP,PTH,and Hcy gradually increased,and HDL gradually decreased with the increase of uric acid level;The results of multivariate linear regression analysis showed that blood uric acid level was positively correlated with TG,CRP,PTH and Hcy(P<0.05),and negatively correlated with HDL(P<0.05).5.The LVPWd,IVSd and LVEDD in the patients with elevated uric acid were higher than those in the normal uric acid group(P<0.05),while the LVEF was lower than the normal uric acid group(P<0.05).Conclusion: 1.The prevalence of HUA in maintenance hemodialysis patients was high,it may be closely related to factors such as massive smoking,heavy drinking,abdominal obesity,and elevated systolic blood pressure.2.The causes of death in maintenance hemodialysis patients were mainly heart and cerebrovascular diseases.HUA may cause cardiovascular disease in maintenance hemodialysis patients through various biochemical indicators such as TG,CRP,PTH,Hcy,HDL and cardiac structural changes,and increase the mortality of maintenance hemodialysis patients,and with the increase in blood uric acid levels,the risk of cardiovascular disease increased.3.Active prevention and treatment of HUA may reduce the incidence of cardiovascular disease in maintenance hemodialysis patients and improve the long-term prognosis of maintenance hemodialysis patients.