Serum Uric Acid and Kidney Disease Measures Independently Predict Cardiovascular and Total Mortality: The Uric Acid Right for Heart Health (URRAH) Project
Background: Serum uric acid predicts the onset and progression of kidney disease, and the occurrence of cardiovascular and all-cause mortality. Nevertheless, it is unclear which is the appropriate definition of hyperuricemia in presence of chronic kidney disease (CKD). Our goal was to study the inde...
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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.713652/full |
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| author | Elisa Russo Francesca Viazzi Roberto Pontremoli Carlo M. Barbagallo Michele Bombelli Edoardo Casiglia Arrigo F. G. Cicero Massimo Cirillo Pietro Cirillo Giovambattista Desideri Lanfranco D'Elia Raffaella Dell'Oro Claudio Ferri Ferruccio Galletti Loreto Gesualdo Cristina Giannattasio Guido Iaccarino Giovanna Leoncini Francesca Mallamaci Alessandro Maloberti Stefano Masi Alessandro Mengozzi Alberto Mazza Maria L. Muiesan Pietro Nazzaro Paolo Palatini Gianfranco Parati Gianfranco Parati Marcello Rattazzi Giulia Rivasi Massimo Salvetti Valérie Tikhonoff Giuliano Tocci Fosca A. L. Quarti Trevano Andrea Ungar Paolo Verdecchia Agostino Virdis Massimo Volpe Guido Grassi Claudio Borghi |
| author_facet | Elisa Russo Francesca Viazzi Roberto Pontremoli Carlo M. Barbagallo Michele Bombelli Edoardo Casiglia Arrigo F. G. Cicero Massimo Cirillo Pietro Cirillo Giovambattista Desideri Lanfranco D'Elia Raffaella Dell'Oro Claudio Ferri Ferruccio Galletti Loreto Gesualdo Cristina Giannattasio Guido Iaccarino Giovanna Leoncini Francesca Mallamaci Alessandro Maloberti Stefano Masi Alessandro Mengozzi Alberto Mazza Maria L. Muiesan Pietro Nazzaro Paolo Palatini Gianfranco Parati Gianfranco Parati Marcello Rattazzi Giulia Rivasi Massimo Salvetti Valérie Tikhonoff Giuliano Tocci Fosca A. L. Quarti Trevano Andrea Ungar Paolo Verdecchia Agostino Virdis Massimo Volpe Guido Grassi Claudio Borghi |
| author_sort | Elisa Russo |
| collection | DOAJ |
| description | Background: Serum uric acid predicts the onset and progression of kidney disease, and the occurrence of cardiovascular and all-cause mortality. Nevertheless, it is unclear which is the appropriate definition of hyperuricemia in presence of chronic kidney disease (CKD). Our goal was to study the independent impact of uric acid and CKD on mortality.Methods: We retrospectively investigated 21,963 patients from the URRAH study database. Hyperuricemia was defined on the basis of outcome specific cut-offs separately identified by ROC curves according to eGFR strata. The primary endpoints were cardiovascular and all-cause mortality.Results: After a mean follow-up of 9.8 year, there were 1,582 (7.20%) cardiovascular events and 3,130 (14.25%) deaths for all causes. The incidence of cardiovascular and all-cause mortality increased in parallel with reduction of eGFR strata and with progressively higher uric acid quartiles. During 215,618 person-years of follow-up, the incidence rate for cardiovascular mortality, stratified based on eGFR (>90, between 60 and 90 and <60 ml/min) was significantly higher in patients with hyperuricemia and albuminuria (3.8, 22.1 and 19.1, respectively) as compared to those with only one risk factor or none (0.4, 2.8 and 3.1, respectively). Serum uric acid and eGFR significantly interact in determining cardiovascular and all-cause mortality. For each SUA increase of 1 mg/dl the risk for mortality increased by 10% even after adjustment for potential confounding factors included eGFR and the presence of albuminuria.Conclusions: hyperuricemia is a risk factor for cardiovascular and all-cause mortality additively to eGFR strata and albuminuria, in patients at cardiovascular risk. |
| first_indexed | 2024-12-22T13:34:29Z |
| format | Article |
| id | doaj.art-dfb82c1f0b1943c3a807bb50540cf67f |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-22T13:34:29Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-dfb82c1f0b1943c3a807bb50540cf67f2022-12-21T18:24:05ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-09-01810.3389/fcvm.2021.713652713652Serum Uric Acid and Kidney Disease Measures Independently Predict Cardiovascular and Total Mortality: The Uric Acid Right for Heart Health (URRAH) ProjectElisa Russo0Francesca Viazzi1Roberto Pontremoli2Carlo M. Barbagallo3Michele Bombelli4Edoardo Casiglia5Arrigo F. G. Cicero6Massimo Cirillo7Pietro Cirillo8Giovambattista Desideri9Lanfranco D'Elia10Raffaella Dell'Oro11Claudio Ferri12Ferruccio Galletti13Loreto Gesualdo14Cristina Giannattasio15Guido Iaccarino16Giovanna Leoncini17Francesca Mallamaci18Alessandro Maloberti19Stefano Masi20Alessandro Mengozzi21Alberto Mazza22Maria L. Muiesan23Pietro Nazzaro24Paolo Palatini25Gianfranco Parati26Gianfranco Parati27Marcello Rattazzi28Giulia Rivasi29Massimo Salvetti30Valérie Tikhonoff31Giuliano Tocci32Fosca A. L. Quarti Trevano33Andrea Ungar34Paolo Verdecchia35Agostino Virdis36Massimo Volpe37Guido Grassi38Claudio Borghi39Department of Internal Medicine, University of Genoa and IRCCS Ospdedale Policlinico San Martino, Genova, ItalyDepartment of Internal Medicine, University of Genoa and IRCCS Ospdedale Policlinico San Martino, Genova, ItalyDepartment of Internal Medicine, University of Genoa and IRCCS Ospdedale Policlinico San Martino, Genova, ItalyBiomedical Department of Internal Medicine and Specialistics, University of Palermo, Palermo, ItalyClinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyStudium Patavinum, Department of Medicine, University of Padua, Padua, ItalyDepartment of Medical and Surgical Science, Alma Mater Studiorum University of Bologna, Bologna, ItalyDepartment of Public Health, Federico II University of Naples Medical School, Naples, ItalyDepartment of Emergency and Organ Transplantation-Nephrology, Dialysis and Transplantation Unit, Aldo Moro University of Bari, Bari, ItalyDepartment of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ItalyDepartment of Clinical Medicine and Surgery, Federico II University of Naples Medical School, Naples, ItalyClinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDepartment of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, ItalyDepartment of Clinical Medicine and Surgery, Federico II University of Naples Medical School, Naples, ItalyDepartment of Emergency and Organ Transplantation-Nephrology, Dialysis and Transplantation Unit, Aldo Moro University of Bari, Bari, Italy0Cardiology IV, A. De Gasperis Department, School of Medicine and Sugery, Niguarda Ca' Granda Hospital, Milano-Bicocca University, Milan, Italy1Department of Advanced Biomedical Sciences, Federico II University of Naples Medical School, Naples, ItalyDepartment of Internal Medicine, University of Genoa and IRCCS Ospdedale Policlinico San Martino, Genova, Italy2CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, Reggio Calabria, Italy0Cardiology IV, A. De Gasperis Department, School of Medicine and Sugery, Niguarda Ca' Granda Hospital, Milano-Bicocca University, Milan, Italy3Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy3Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy4Department of Internal Medicine, Hypertension Unit, General Hospital, Rovigo, Italy5Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy6Department of Medical Basic Sciences, Neurosciences and Sense Organs, University of Bari Medical School, Bari, ItalyStudium Patavinum, Department of Medicine, University of Padua, Padua, Italy7Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy8Department of Cardiology, San Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy9Department of Medicine, Ca' Foncello University Hospital, University of Padova, Treviso, Italy0Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, Florence, Italy5Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy1Department of Medicine, University of Padua, Padua, Italy2Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome Sapienza, Rome, ItalyClinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy0Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, Florence, Italy3Hospital S. Maria della Misericordia, Perugia, Italy3Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy2Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome Sapienza, Rome, ItalyClinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDepartment of Medical and Surgical Science, Alma Mater Studiorum University of Bologna, Bologna, ItalyBackground: Serum uric acid predicts the onset and progression of kidney disease, and the occurrence of cardiovascular and all-cause mortality. Nevertheless, it is unclear which is the appropriate definition of hyperuricemia in presence of chronic kidney disease (CKD). Our goal was to study the independent impact of uric acid and CKD on mortality.Methods: We retrospectively investigated 21,963 patients from the URRAH study database. Hyperuricemia was defined on the basis of outcome specific cut-offs separately identified by ROC curves according to eGFR strata. The primary endpoints were cardiovascular and all-cause mortality.Results: After a mean follow-up of 9.8 year, there were 1,582 (7.20%) cardiovascular events and 3,130 (14.25%) deaths for all causes. The incidence of cardiovascular and all-cause mortality increased in parallel with reduction of eGFR strata and with progressively higher uric acid quartiles. During 215,618 person-years of follow-up, the incidence rate for cardiovascular mortality, stratified based on eGFR (>90, between 60 and 90 and <60 ml/min) was significantly higher in patients with hyperuricemia and albuminuria (3.8, 22.1 and 19.1, respectively) as compared to those with only one risk factor or none (0.4, 2.8 and 3.1, respectively). Serum uric acid and eGFR significantly interact in determining cardiovascular and all-cause mortality. For each SUA increase of 1 mg/dl the risk for mortality increased by 10% even after adjustment for potential confounding factors included eGFR and the presence of albuminuria.Conclusions: hyperuricemia is a risk factor for cardiovascular and all-cause mortality additively to eGFR strata and albuminuria, in patients at cardiovascular risk.https://www.frontiersin.org/articles/10.3389/fcvm.2021.713652/fullhyperuricemiaeGFRalbuminuriacardiovascular mortalityall-cause mortality |
| spellingShingle | Elisa Russo Francesca Viazzi Roberto Pontremoli Carlo M. Barbagallo Michele Bombelli Edoardo Casiglia Arrigo F. G. Cicero Massimo Cirillo Pietro Cirillo Giovambattista Desideri Lanfranco D'Elia Raffaella Dell'Oro Claudio Ferri Ferruccio Galletti Loreto Gesualdo Cristina Giannattasio Guido Iaccarino Giovanna Leoncini Francesca Mallamaci Alessandro Maloberti Stefano Masi Alessandro Mengozzi Alberto Mazza Maria L. Muiesan Pietro Nazzaro Paolo Palatini Gianfranco Parati Gianfranco Parati Marcello Rattazzi Giulia Rivasi Massimo Salvetti Valérie Tikhonoff Giuliano Tocci Fosca A. L. Quarti Trevano Andrea Ungar Paolo Verdecchia Agostino Virdis Massimo Volpe Guido Grassi Claudio Borghi Serum Uric Acid and Kidney Disease Measures Independently Predict Cardiovascular and Total Mortality: The Uric Acid Right for Heart Health (URRAH) Project Frontiers in Cardiovascular Medicine hyperuricemia eGFR albuminuria cardiovascular mortality all-cause mortality |
| title | Serum Uric Acid and Kidney Disease Measures Independently Predict Cardiovascular and Total Mortality: The Uric Acid Right for Heart Health (URRAH) Project |
| title_full | Serum Uric Acid and Kidney Disease Measures Independently Predict Cardiovascular and Total Mortality: The Uric Acid Right for Heart Health (URRAH) Project |
| title_fullStr | Serum Uric Acid and Kidney Disease Measures Independently Predict Cardiovascular and Total Mortality: The Uric Acid Right for Heart Health (URRAH) Project |
| title_full_unstemmed | Serum Uric Acid and Kidney Disease Measures Independently Predict Cardiovascular and Total Mortality: The Uric Acid Right for Heart Health (URRAH) Project |
| title_short | Serum Uric Acid and Kidney Disease Measures Independently Predict Cardiovascular and Total Mortality: The Uric Acid Right for Heart Health (URRAH) Project |
| title_sort | serum uric acid and kidney disease measures independently predict cardiovascular and total mortality the uric acid right for heart health urrah project |
| topic | hyperuricemia eGFR albuminuria cardiovascular mortality all-cause mortality |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.713652/full |
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