| Objective:To explore the relationship between different degrees of serum uric acid levels and cardiovascular events in peritoneal dialysis patients.Methods:The newly admitted peritoneal dialysis patients in the First Affiliated Hospital of Nanchang University peritoneal dialysis center during the February 1,2010 to May31,2019 were enrolled.The serum uric acid level at six months of dialysis was divided into four groups: G1 group: serum uric acid < 360μmol / L;G2 group:360μmol/L≤serum uric acid<420μmol/L;G3 group: 420μmol/L≤serum uric acid<480μmol/L;G4 group: serum uric acid ≥480μmol/L.The clinical characteristics of the four groups of patients were compared.The G2 group was used as the control group,logistics regression analysis was used to analyze the relationship between serum uric acid level at 6 months of peritoneal dialysis and cardiovascular events.Results:A total of 728 peritoneal dialysis patients were included in this study,including403(55.4%)males and 325(44.6%)females,with an average age of 48.66±13.98 years,158(21.7%)cardiovascular events,the average time of cardiovascular events was 31.42±20.75 months,121(16.6%)patients with diabetes,552(75.8%)patients with hypertension,505(69.4%)patients with chronic glomerulonephritis,88(12.1%)patients with diabetic nephropathy and 80(11.0%)patients with hypertensive nephropathy,the mean value of serum uric acid at 6 months of peritoneal dialysis was404.65±81.92μmol/L.After grouping,there were 198(27.2%)cases in the G1 group,259(35.6%)cases in the G2 group,157(21.6%)cases in the G3 group,114(15.7%)cases in the G4 group,the incidence of cardiovascular events were 47(23.7%),36(13.9%),44(28.0%)and 31(27.2%)respectively.(1)The number of cardiovascularevents,the proportion of diabetic nephropathy,high density lipoprotein cholesterol,initial total Kt/V,and total Kt/V at 6 months of peritoneal dialysis were higher in the G1 group than those in the G2 group(P< 0.05),while the proportion of men,BMI(Body Mass Idex)value,serum albumin,serum creatinine,blood urea nitrogen,initial serum uric acid and serum phosphorus levels were lower(P< 0.05).(2)The proportion of cardiovascular events,hemoglobin,initial serum uric acid level,initial residual renal function,and residual renal function at 6 months of dialysis were higher in the G3 group than those in the G2 group(P< 0.05),while serum creatinine and phosphorus levels were lower(P< 0.05).(3)The proportion of cardiovascular events,BMI value,initial serum uric acid level,and initial residual renal function were higher in the G4 group than those in the G2 group(P< 0.05),while serum creatinine and high density lipoprotein cholesterol levels were lower(P< 0.05).(4)Univariate logistic regression analysis showed that males(OR = 1.47,95% CI = 1.02-2.11,P =0.04),systolic blood pressure(OR = 1.01,95% CI = 1.00-1.02,P = 0.002),G1 group(OR = 1.93,95% CI = 1.20-3.12,P = 0.007),G3 group(OR = 2.41,95% CI =1.47-3.96,P = 0.007),G4 group(OR% CI = 1.35-3.98,P=0.002),and diabetic nephropathy as the primary disease(OR=1.83,95% CI=1.12-2.98,P=0.02)had a higher risk of cardiovascular events,while chronic glomerulonephritis as the primary disease(OR = 0.59,95% CI = 0.41-0.85,P = 0.01)had a lower risk of cardiovascular events.(5)Multivariate logistics regression analysis found that systolic blood pressure(OR = 1.01,95% CI = 1.00-1.02,P = 0.02),G1 group(OR = 1.91,95% CI =1.16-3.16,P = 0.01),G3 group(OR = 2.05,95% CI = 1.22-3.45,P = 0.007),G4group(OR = 2.40,95% CI = 1.36-4.25,P = 0.003)were independent risk factors for cardiovascular events.Conclusion:Serum uric acid levels at 6 months of peritoneal dialysis was significantly associated with cardiovascular events in peritoneal dialysis patients,and too low or high serum uric acid levels were independent risk factors for cardiovascular events. |
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