Relationship between serum uric acid, all-cause mortality and cardiovascular mortality in peritoneal dialysis patients: systematic review and meta-analysis of cohort studies

Abstract

ObjectivesTo 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.DesignA systematic review of observational studies.Data sourcesPubMed, 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.MethodsThe 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.ResultsFourteen 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.ConclusionsResults 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.

Serum uric acid level and all-cause and cardiovascular mortality in peritoneal dialysis patients: A systematic review and dose-response meta-analysis of cohort studies

“…In addition, Anderson [ 41 ] reported a systematic review and meta-analysis of death risk prediction for patients starting dialysis, unfortunately, the relationship between SUA and death was not explored. A recent meta-analysis by Xue et al [ 42 ] explored the relationship between SUA and all-cause and CVD mortality in PD patients and found that the results of prospective and retrospective cohort studies were inconsistent. However, they did not research the impact of intermediate levels of SUA on mortality compared with the highest and lowest levels.…”

A systematic review and meta-analysis of risk factors for reoperation after degenerative lumbar spondylolisthesis surgery

“…The following data were extracted: the first author, year of publication, country, study design, patients, definition of spondylolisthesis, sample size, age, sex, BMI, disease duration, surgery types, follow-up time, number of reoperations, reasons for reoperation, reoperation methods, and risk factors of reoperation. The Newcastle–Ottawa Scale (NOS) was applied to evaluate the quality of cohort studies [ 15 ]. This scale consisted of three items: selection, comparability, and outcome.…”

“…This scale consisted of three items: selection, comparability, and outcome. This scale was scored a total of 9 points, and divided into low quality (0–3 points), fair quality (4–6 points), and high quality (7–9 points) [ 15 ].…”