血尿酸/血肌酐比值与维持性血液透析患者残余肾功能的关系及其对预后的预测价值OA

Objective To explore the relationship between serum uric acid/serum creatinine ratio(SUA/Scr)and residual renal function(RRF)in maintenance hemodialysis patients and its prognostic prediction value.Methods A total of 120 patients with chronic kidney disease who underwent maintenance hemodialysis at the Sixth People's Hospital of Zhoukou from March 2022 to March 2024 were enrolled.According to RRF values,patients were divided into an RRF group(n=22)and a non-RRF group(n=98).After one year of follow-up,patients were divided into a survival group(n=91)and a death group(n=29)based on prognosis.Serum uric acid(SUA),serum creatinine(Scr),and SUA/Scr ratio were compared among all patients.Spearman correlation analysis was used to assess the correlation of SUA,Scr,SUA/Scr with RRF.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the prognostic value of SUA,Scr,and SUA/Scr.Multivariate logistic stepwise regression analysis was used to identify factors influencing the prognosis of maintenance hemodialysis patients.Results The level of SUA,Scr,and SUA/Scr ratio in the non-RRF group were(774.95±70.49)μmol/L,(435.82±34.8)μmol/L,and(1.78±0.16),respectively,which were significantly higher than those in the RRF group[(576.83±52.54)μmol/L,(380.17±26.61)μmol/L,and(1.52±0.13)],with statistically significant differences(t=12.414,7.033,7.106,P<0.001).SUA,Scr,and the SUA/Scr ratio were negatively correlated with RRF(r=-0.629,-0.483,-0.657,P<0.05).The levels of SUA,Scr,and SUA/Scr ratio in the death group were[(797.94±67.41)μ mol/L,(459.06±39.72)μmol/L,and(1.74±0.13)],respectively,which were significantly higher than those of the survival group[(524.23±41.93)μmol/L,(385.49±30.83)μmol/L,and(1.36±0.11)],with statistically significant differences(t=26.097,10.406,15.488,P<0.001).ROC curve analysis showed that the areas under the curve(AUC)of SUA,Scr,and SUA/Scr ratio for predicting the prognosis of maintenance hemodialysis patients were 0.803,0.729,and 0.901,respectively.The proportions of hyperphosphatemia,diabetes,and hypertension in the death group were significantly higher than those in the survival group,while the levels of albumin,serum calcium,and the proportion of RRF were significantly lower than those in the survival group,with statistically significant differences(χ2/t=8.187,4.611,6.221,11.906,8.186,4.424,P<0.05).Multivariate logistic stepwise regression analysis showed that hypertension,diabetes,albumin,RRF,and the SUA/Scr ratio were influencing factors for the prognosis of maintenance hemodialysis patients(OR=1.885,95%CI:1.025-3.468,P=0.041;OR=2.261,95%CI:1.184-4.318,P=0.013;OR=2.477,95%CI:1.142-5.372,P=0.022;OR=2.545,95%CI:1.351-4.793,P=0.004;OR=3.071,95%CI:1.788-5.275,P<0.001).Conclusions The SUA/Scr ratio is negatively correlated with RRF in maintenance hemodialysis patients,and its elevation has an independent predictive value for the risk of all-cause mortality.