ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2017
Serum uric acid, protein intake and mortality in hemodialysis patients.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.
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Who cites it
43 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 citations in OpenAlex.
- Pooled it
- Genotype-Informed Characterization of Mild Renal Hypouricemia.Kidney international reports · 2026Article
- Serum uric acid-to-albumin ratio as a novel predictor of all-cause mortality and cardiovascular events in hemodialysis patients: a retrospective cohort study.Frontiers in nutrition · 2026Article
- Associations between High Protein Intake and Cardiovascular Diseases by Age Groups: A Cohort Study.The journal of nutrition, health & aging · 2026Article
- Low Serum Uric Acid as an Independent Predictor of Mortality and Poor Prognosis: A Retrospective Cohort Study.Journal of clinical medicine · 2025Article
- Serum Uric Acid Level as an Estimated Parameter That Predicts All-Cause Mortality in Patients with Hemodialysis.Journal of personalized medicine · 2025Article
- Hyperuricemia prevalence and its risk factors in uremic patients undergoing maintenance hemodialysis.BMC nephrology · 2025Article
- The impact of serum uric acid on biological aging and mortality risk: insights from the NHANES and CHARLS cohorts.Frontiers in nutrition · 2025Article
- The Uric Acid to Albumin Ratio Predicts All-cause and Cardiovascular Mortality Among U.S. Adults Results from the National Health and Nutrition Examination Survey in 2003-2018.International journal of medical sciences · 2025Article
- Long-Term Survival of Patient with End-Stage Renal Disease Using Bayesian Mixture Cure Rate Frailty Models.Iranian journal of public health · 2024Article
- Uric acid to albumin ratio is a novel predictive marker for all-cause and cardiovascular death in diabetic patients: a prospective cohort study.Frontiers in endocrinology · 2024Article
- Association between serum uric acid and all-cause and cardiovascular-related mortality in hemodialysis patients.Frontiers in nutrition · 2024Article
- Association between serum uric acid levels and clinical outcomes in patients with acute kidney injury.Renal failure · 2023Article
- J-shaped association between uric acid and breast cancer risk: a prospective case-control study.Journal of cancer research and clinical oncology · 2023Article
- Increased prevalence of periodontitis with hypouricemic status: findings from the Korean National Health and Nutrition Examination Survey, 2016-2018.Journal of periodontal & implant science · 2023Article
- Article
- Association between serum uric acid and phase angle in patients with type 2 diabetes mellitus: A cross-sectional study.Frontiers in endocrinology · 2023Article
- Urate-lowering therapy for patients with gout on hemodialysis.International journal of rheumatic diseases · 2022Article
- The dialysis facility levels and sizes are associated with outcomes of incident hemodialysis patients.Scientific reports · 2021Article
- Association between serum uric acid level and mortality in China.Chinese medical journal · 2021Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe association between serum uric acid (SUA) and mortality has been conflicting among studies using hemodialysis (HD) patients. Given the close link between purine and protein in foods, we hypothesized that normalized protein catabolic rate (nPCR), a dietary protein intake surrogate, modifies the SUA-mortality association in the HD population.
methodsWe identified 4298 patients who initiated HD and had one or more SUA measurement in a contemporary cohort of HD patients over 5 years (1 January 2007-31 December 2011), and examined survival probability according to the first uric acid measurement, adjusting for dialysis vintage, case-mix and malnutrition-inflammation complex-related variables.
resultsMean SUA concentration was 6.6 ± 1.8 mg/dL. There was a consistent association of higher SUA with better nutritional status and lower all-cause mortality irrespective of adjusted models (Ptrend < 0.001). In the case-mix adjusted model, the highest SUA category (≥8.0 mg/dL) compared with the reference group (>6.0-7.0 mg/dL) showed no significant mortality risk [hazard ratio (HR) 0.90, 95% confidence interval (CI) 0.72-1.13], while the lowest category (<5.0 mg/dL) was associated with higher mortality (HR 1.42, 95% CI 1.16-1.72). The hypouricemia-mortality association was significantly modified by nPCR (Pinteraction = 0.001). Mortality risk of low SUA (<5.0 mg/dL) persisted among patients with low nPCR (<0.9 g/kg/day; HR 1.73, 95% CI 1.42-2.10) but not with high nPCR (≥0.9 g/kg/day; HR 0.99, 95% CI 0.74-1.33).
conclusionsSUA may be a nutritional marker in HD patients. Contrary to the general population, low but not high SUA is associated with higher all-cause mortality in HD patients, especially in those with low protein intake. Nutritional features of SUA warrant additional studies.
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