ASYMPTOMATIC HYPERURICEMIA AS A RISK FACTOR OF OUTCOME IN CARDIORENAL PATIENTS

Abstract Objective The purpose of the study was to evaluate the impact of asymptomatic hyperuricemia on long-term outcome including death, rehospitalization in cardiorenal patients. Introduction Hyperuricemia is associated with progression of kidney failure, cardiovascular diseases and cardiorenal syndrome, which represents a significant health burden. There is a growing interes on evaluation of serum acid levels(SUA) as a risk factor in cardiorenal syndrome, because of the evidences that xanthine oxidase inhibitors are satisfactorily useful on cardio and renal protection. Materials and Methods This was a descriptive cross–sectional study. A two-years follow up was conducted to determine the outcome in cardiorenal patients. Each patient went through clinical examination with a standard valuation including the determination of uric acid levels. 139 patients (pts) with chronic kidney disease stage 3 from whom 119 had cardiorenal syndrome were included in the study. Statistical analysis was performed by χ2 test, Fisher's exact test and binary logistic regression. Results Hyperuricemia was founded in 65.5% of pts determined by acid uric levels higher then 7.2 mg/dl and had a strong assosiation with cardiorenal syndrome,p=0.03.The average age was 56.7 ± 12.5 years. Males were 62.2%% pts, p=0.031. Bivariate analysis revealed a strong relationship between hyperurcemia and cardiovascular components: hypertension p=0.047, diabetes mellitus p=0.021, sex p=0.03, death p=0.051 and rehospitalization in 18 pts, p=0.02. Subsequently binary logistic regression showed that higher acid uric levels even there were not statistically correlated with mortality, were a significant predictor for all-cause death (Odds Ratio [OR] 4.2, 95% confidence interval [CI] 0.87–20.35, p = 0.073). Conclusions Asymptomatic hyperuricemia was common and had a powerfull significant association with cardiorenal syndrome.Higher SUA was unconventionally associated with long-term adverse outcomes in these patients, so our efforts should be focused in immediate identification and treatment of this old forbidden marker. Key words chromic kidney disease, cardiovascular disease, etc