Hyperuricemia Predicts Residual Diuresis Decline in Peritoneal Dialysis Patients

Introduction. The effect of serum uric acid (SUA) concentration on residual urine volume in peritoneal dialysis (PD) patients has not been postulated yet. The present study aimed to investigate the effect of SUA concentration on residual diuresis in PD patients.
Methods. It was a retrospective observational study involving 175 patients who were treated with PD for at least 3 months. The primary study outcome was residual dieresis decline<100 mL/24h represented as the time to onset of anuria.
Results. A total of 175 PD patients with the median PD vintage of 13.5 [5.0-19.7] months before the enrollment were included in the study. Among the participants, there were 79 (45.2%) men and 96 (54.8%) women. Hyperuricemia was found in 48/79 (60.8%) men and 39/96 (40.6%) women (p=0.008). Residual renal function was significantly lower in the PD patients with hyperuricemia compared with the hyperuricemia-free patients. During a 22.5 [15.8-28.3] month follow-up period, 64 (42.3%) PD patients progressed to anuria and its prevalence was significantly higher in the hyperuricemic group compared with the normouricemic group (64.3% vs 20.4%, p <0.001). The multivariate logistic regression analysis demonstrated that hyperuricemia was an independent risk factor associated with the development of anuria in PD patients. The additional Cox regression analysis confirmed hyperuricemia as a predictor for anuria development in the PD patients: HR 2.6 (95% CI 1.38; 4.9), p=0.003.
Conclusions. Hyperuricemia is an independent risk factor for residual diuresis decline < 100 mL/24h in PD patients.