Patients with chronic kidney disease often have both metabolic syndrome and hyperuricemia, which are indicative of underlying inflammatory and metabolic dysregulation. Endothelial dysfunction, insulin resistance, and accelerated atherosclerosis are associated with both diseases. They may play a significant role as prognostic indicators, since new data indicates that their existence in CKD patients is linked to increased cardiovascular and all-cause mortality. Thus, this study investigated the relationship between all-cause and cardiovascular mortality in patients with chronic kidney disease and metabolic syndrome and hyperuricemia.
MetS (≥ 3 of 5 criteria), HUA (> 7.0 mg/dL in men, > 6.0 mg/dL in females), and estimated glomerular filtration rate (< 60 mL/min/1.73 m2 or urine albumin creatinine ratio > 3 mg/mmol) were used to examine 28,278 individuals with CKD. Cardiovascular and all-cause mortality were among the results. Multivariate-adjusted Cox proportional hazards models and Kaplan-Meier survival analysis were used to evaluate associations; subgroup analyses and sensitivity testing were included.
3564 all-cause fatalities (17.28%) were reported over a median follow-up of 13.21 years, of which 1025 (4.97%) were related to cardiovascular causes. Both HUA and MetS were significantly linked to cardiovascular and all-cause mortality after many adjustments. The risk of all-cause death (adjusted hazard ratio [aHR] = 1.45, 95% confidence interval [CI]: 1.30–1.62) and cardiovascular mortality (aHR = 2.09, 95% CI: 1.70–2.58) was considerably greater in patients with CKD who also had concomitant HUA or MetS.
Elevated uric acid levels and a high number of MetS components significantly decreased survival probability (P < 0.001), according to Kaplan–Meier curves, which showed an increasing trend as uric acid levels and the number of MetS components rose. The robustness and consistency of these results were validated by subgroup and sensitivity analysis. Overall, MetS and HUA were important risk factors for death in CKD patients. In individuals with high UA levels and a large number of MetS components, their cohabitation showed a synergistic impact that increased the risk of cardiovascular and all-cause death.
Source:
Wu, C., Pan, C., Liu, L., & Li, W. (2025). Association of metabolic syndrome and hyperuricemia with mortality in patients with chronic kidney disease: a UK biobank study. BMC Nephrology, 26(1), 696. https://doi.org/10.1186/s12882-025-04615-0
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