Cardiovascular events in pre-dialysis and dialysis patients with Hyperuricemia

Background: Hyperuricemia in chronic kidney disease (CKD) could increase the risk of developing cardiovascular disease (CVD). It is necessary to emphasize the need to identify patients with hyperuricemia and CKD for early prevention with reducing the levels of high serum uric acid (SUA). The aim of the study was to evaluate and compare the type of cardiovascular diseases among patients with hyperuricemia in pre-dialysis CKD stages and on dialysis treatment. Methods: We performed a retrospective study in two centers on 58 adult patients – 36 in pre-dialysis stage and 22 on chronic dialysis treatment with hyperuricemia and CVD. The pre-dialysis patients were with chronic kidney disease from second to the fourth stage. Chi-square test, independent samples T-test, and nonparametric Mann-Whitney U Test were used. Results: We observed that atrial fibrillation (AF) was the most common finding in the two groups and it was established in 29 (80,56%) pre-dialysis and in 17 (77,27%) dialysis patients. Ischemic heart disease (IHD) was found significantly more often in a pre-dialysis group, but the dialysis patients had higher cerebrovascular disease incidence. The incidence of IHD was higher in pre-dialysis female patients, while heart blocks were with a higher rate in dialysis females. Cerebrovascular disease and heart blocks were more often in male patients on dialysis treatment. Intragroup analysis of CVD in the pre-dialysis patients according to the genders suggested a higher rate of IHD and heart blocks in males. The same analysis in hemodialysis patients indicated that the women have a higher rate of cerebrovascular disease and AF, while men were more often with IHD and heart blocks. Conclusions: We supposed that patients with Hu, independently of the stage of CKD were with the highest incidence of AF, but there were differences in the type of CVD between the pre-dialysis and dialysis patients that were also gender specific.