Relationship between serum uric acid, all-cause mortality and cardiovascular mortality in peritoneal dialysis patients: systematic review and meta-analysis of cohort studies
Objectives To analyse the relationship between serum uric acid (SUA), all-cause and cardiovascular (CV) mortality in peritoneal dialysis (PD) patients to inform clinical practice and future research.Design A systematic review of observational studies.Data sources PubMed, Embase, Web of Science, the...
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BMJ Publishing Group
2021-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/10/e052274.full |
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| author | Qiang Liu Min Yang Nicola Robinson Hong Cheng Jian-Ping Liu Xue Xue Chun-Li Lu Xin-Yan Jin Xue-Han Liu Xiao-Qin Wang Jun Yuan Ruo-Xiang Zheng |
| author_facet | Qiang Liu Min Yang Nicola Robinson Hong Cheng Jian-Ping Liu Xue Xue Chun-Li Lu Xin-Yan Jin Xue-Han Liu Xiao-Qin Wang Jun Yuan Ruo-Xiang Zheng |
| author_sort | Qiang Liu |
| collection | DOAJ |
| description | Objectives To analyse the relationship between serum uric acid (SUA), all-cause and cardiovascular (CV) mortality in peritoneal dialysis (PD) patients to inform clinical practice and future research.Design A systematic review of observational studies.Data sources PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), SinoMed, Chinese Science and Technology Journal Database (VIP) and Wan Fang databases were searched from their inception to January 2021 for cohort and case–control studies reporting SUA and mortality in patients with PD.Methods The Newcastle-Ottawa Quality Assessment Scale was used to appraise quality of cohort and case–control studies. Effect estimates were presented as HRs with 95% CIs in a meta-analysis using STATA V.16.0. Data not suitable for pooling were synthesised qualitatively.Results Fourteen cohort studies with 24 022 patients were included. No case–control studies were identified. For prospective cohort studies, pooled results for the highest SUA category were significantly greater than the lowest for all-cause (one study; 1278participants; HR 1.79; 95% CI 1.17 to 2.75) and CV mortality (one study; 1278 participants; HR 2.63; 1.62–4.27). An increase of 1 mg/dL in SUA level was associated with a 16% increased risk of all-cause mortality (one study; 1278 participants; HR 1.16; 1.03–1.32) and 34% increased CV mortality risk (one study; 1278 participants; HR 1.34; 1.16–1.55). For retrospective cohort studies, the highest SUA category did not demonstrate an elevated all-cause (five studies; 4570 participants; HR 1.09; 0.70–1.70) or CV mortality (three studies; 3748 participants; HR 1.00; 0.44–2.31) compared with the lowest SUA category. Additionally, there was no increase in all-cause (eight studies; 11 541 participants; HR 0.94; 0.88–1.02) or CV mortality (three studies; 7427 participants; HR 0.90; 0.76–1.06) for every 1 mg/dL increase in SUA level.Conclusions Results of prospective and retrospective cohort studies were inconsistent. Consequently, prospective, multicentre, long-term follow-up studies are required to confirm the relationship between SUA and mortality in patients with PD. |
| format | Article |
| id | doaj-art-cd5b1fa7b28d4343937e5877829a77b4 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-10-01 |
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| spelling | doaj-art-cd5b1fa7b28d4343937e5877829a77b42025-08-20T02:23:44ZengBMJ Publishing GroupBMJ Open2044-60552021-10-01111010.1136/bmjopen-2021-052274Relationship between serum uric acid, all-cause mortality and cardiovascular mortality in peritoneal dialysis patients: systematic review and meta-analysis of cohort studiesQiang Liu0Min Yang1Nicola Robinson2Hong Cheng3Jian-Ping Liu4Xue Xue5Chun-Li Lu6Xin-Yan Jin7Xue-Han Liu8Xiao-Qin Wang9Jun Yuan10Ruo-Xiang Zheng111 Department of Pathology, Albert Einstein College of Medicine, Bronx, New York, USADepartment of Rheumatology and Immunology, Southern Medical University, Guangzhou, Guangdong, China3Northern Endoscopy AcademyDepartment of Nephrology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, ChinaBeijing University of Chinese Medicine, Beijing, ChinaFirst Clinical College and Affiliated Hospital, Hubei University of Traditional Chinese Medicine, Wuhan, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Nephrology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, ChinaCollege of Public Health, Chongqing Medical University, Chongqing, ChinaCentre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, ChinaObjectives To analyse the relationship between serum uric acid (SUA), all-cause and cardiovascular (CV) mortality in peritoneal dialysis (PD) patients to inform clinical practice and future research.Design A systematic review of observational studies.Data sources PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), SinoMed, Chinese Science and Technology Journal Database (VIP) and Wan Fang databases were searched from their inception to January 2021 for cohort and case–control studies reporting SUA and mortality in patients with PD.Methods The Newcastle-Ottawa Quality Assessment Scale was used to appraise quality of cohort and case–control studies. Effect estimates were presented as HRs with 95% CIs in a meta-analysis using STATA V.16.0. Data not suitable for pooling were synthesised qualitatively.Results Fourteen cohort studies with 24 022 patients were included. No case–control studies were identified. For prospective cohort studies, pooled results for the highest SUA category were significantly greater than the lowest for all-cause (one study; 1278participants; HR 1.79; 95% CI 1.17 to 2.75) and CV mortality (one study; 1278 participants; HR 2.63; 1.62–4.27). An increase of 1 mg/dL in SUA level was associated with a 16% increased risk of all-cause mortality (one study; 1278 participants; HR 1.16; 1.03–1.32) and 34% increased CV mortality risk (one study; 1278 participants; HR 1.34; 1.16–1.55). For retrospective cohort studies, the highest SUA category did not demonstrate an elevated all-cause (five studies; 4570 participants; HR 1.09; 0.70–1.70) or CV mortality (three studies; 3748 participants; HR 1.00; 0.44–2.31) compared with the lowest SUA category. Additionally, there was no increase in all-cause (eight studies; 11 541 participants; HR 0.94; 0.88–1.02) or CV mortality (three studies; 7427 participants; HR 0.90; 0.76–1.06) for every 1 mg/dL increase in SUA level.Conclusions Results of prospective and retrospective cohort studies were inconsistent. Consequently, prospective, multicentre, long-term follow-up studies are required to confirm the relationship between SUA and mortality in patients with PD.https://bmjopen.bmj.com/content/11/10/e052274.full |
| spellingShingle | Qiang Liu Min Yang Nicola Robinson Hong Cheng Jian-Ping Liu Xue Xue Chun-Li Lu Xin-Yan Jin Xue-Han Liu Xiao-Qin Wang Jun Yuan Ruo-Xiang Zheng Relationship between serum uric acid, all-cause mortality and cardiovascular mortality in peritoneal dialysis patients: systematic review and meta-analysis of cohort studies BMJ Open |
| title | Relationship between serum uric acid, all-cause mortality and cardiovascular mortality in peritoneal dialysis patients: systematic review and meta-analysis of cohort studies |
| title_full | Relationship between serum uric acid, all-cause mortality and cardiovascular mortality in peritoneal dialysis patients: systematic review and meta-analysis of cohort studies |
| title_fullStr | Relationship between serum uric acid, all-cause mortality and cardiovascular mortality in peritoneal dialysis patients: systematic review and meta-analysis of cohort studies |
| title_full_unstemmed | Relationship between serum uric acid, all-cause mortality and cardiovascular mortality in peritoneal dialysis patients: systematic review and meta-analysis of cohort studies |
| title_short | Relationship between serum uric acid, all-cause mortality and cardiovascular mortality in peritoneal dialysis patients: systematic review and meta-analysis of cohort studies |
| title_sort | relationship between serum uric acid all cause mortality and cardiovascular mortality in peritoneal dialysis patients systematic review and meta analysis of cohort studies |
| url | https://bmjopen.bmj.com/content/11/10/e052274.full |
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