Correlation Between Serum Uric Acid Level And Cardiovascular Events And Nutritional Status In Peritoneal Dialysis Patients

Objective: To evaluate the correlation between serum uric acid level and cardiovascular events and nutritional status in peritoneal dialysis patients.Methods: Retrospective analysis was made on continuous ambulatory peritoneal dialysis(CAPD)from January 1,2016 to June 30,2018 in the Department of Nephrology,Third Hospital of Hebei Medical University.97 patients were followed up regularly for more than 5 months.The patients were divided into hyperuricemia group and normal uric acid group according to the patient's uric acid level after regular peritoneal dialysis for 5-7 months(the normal range of uric acid in the third hospital of Hebei medical university: 202-416?mol/L for males and 142-340 ?mol/L for females).The difference of incidence rate of cardiovascular events between the two groups was compared,and the relationship between serum uric acid level of the two groups and clinical and biochemical indexes reflecting nutritional status of patients,such as BMI,total protein,albumin,hemoglobin,urea nitrogen,creatinine,triglyceride,total cholesterol,electrolyte,etc.were analyzed.Results: Unitary linear regression analysis of 97 peritoneal dialysis patients included in this study showed that the level of serum uric acid in male peritoneal dialysis patients was higher than that in female patients(B=62.732,P=0.000),and the level of uric acid was positively correlated with the levels of BMI(B=7.647,P=0.01),serum albumin(B=3.089,P=0.045),urea nitrogen(B=1.391,P=0.01)and serum magnesium(B=167.425,P=0.002).However,it is negatively correlated with the patients' age(B=-1.127,P=0.048),iPTH(B=-0.6,P=0.046),dialysis Kt/v(B=-91.951,P=0.000).Further multiple linear regression analysis showed that the level of uric acid in male patients was higher(B=39.457,P=0.011),and the level of serum uric acid was positively correlated with serum magnesium(B=121.744,P=0.012),but negatively correlated with dialysis Kt/v(B=-64.094,P=0.03).According to the level of serum uric acid,46 patients(47%)with hyperuricemia and 51 patients(53%)with normal serum uric acid were divided into groups.Compared with the patients in the normal serum uric acid group,the levels of total protein(t=2.123,P=0.036)and serum magnesium(t=2.019,P=0.046)were higher than hyperuricemia patients,while the levels of parathyroid hormone(Z=-2.885,P=0.004)and dialysis Kt/v(t=-2.997,P=0.003)were lower.There was no significant difference in the incidence of cardiovascular events between the two groups(?2=0.308,P=0.134).Furthermore,there were no significant difference in the incidences of cardiovascular events between diabetic patients(?2=1.709,P=0.191),non-diabetic patients(?2=0.115,P=0.735),male patients(?2=0.888,P=0.346)and female patients(?2=0.142,P=0.706).Logistic regression analysis of the influencing factors of cardiovascular events in peritoneal dialysis patients showed that the occurrence of cardiovascular events was positively correlated to patients' serum creatinine(OR=1.002,95% CI: 1.000-1.004,P=0.019),urea nitrogen(OR=1.163,95% CI: 1.052-1.287,P=0.003),serum phosphorus(OR= 5.059,95% CI: 1.537-16.653,P=0.008),but negatively correlated with dialysis Kt/v(OR= 0.169,95% CI: 0.034-0.831,P=0.029).Conclusions: 1.Elevated serum uric acid level in peritoneal dialysis patients does not affect the incidence of cardiovascular events.2.Cardiovascular events in peritoneal dialysis patients are positively correlated with serum creatinine,urea nitrogen and serum phosphorus,but negatively correlated with dialysis Kt/v;3.Elevated serum uric acid indicates better nutritional status of peritoneal dialysis patients.