Serum uric acid and arterial stiffness in hypertensive chronic kidney disease patients: sex-specific variations

Objective Hyperuricemia and arterial stiffness are associated with increased cardiovascular risk. The specific relationship between arterial stiffness and serum uric acid (SUA) in chronic kidney disease (CKD) patients has not been investigated. We investigated whether the SUA level is associated with arterial stiffness in hypertensive CKD patients. Materials and methods This study had a single-center, cross-sectional design. A total of 339 hypertensive CKD patients (female/male= 192/147, mean age 57.9 +/- 13.9 years) were recruited. Arterial stiffness was assessed by pulse wave velocity (PWV) and augmentation index adjusted for heart rate (AIx@75). Results SUA was correlated negatively with night-time wave reflection magnitude (P = 0.015), 24-h AIx@75 (P < 0.0001), daytime AIx@75 (P < 0.0001), and night-time AIx@75 (P = 0.014), and was correlated positively with 24-h PWV (P < 0.0001), daytime PWV (P < 0.0001), and night-time PWV (P < 0.0001). SUA was correlated negatively with 24-h AIx@75 (P = 0.024), daytime AIx@75 (P = 0.023), and night-time AIx@75 (P = 0.047) in men, whereas SUA was correlated positively with 24-h PWV (P < 0.0001), daytime PWV (P < 0.0001), and night-time PWV (P < 0.0001) in women. In adjusted analysis, SUA was associated independently with AIx@75, but not with PWV. In sex-specific unadjusted analysis, SUA was associated significantly with PWV only in women, which lost significance in adjusted analysis. SUA was associated significantly with AIx@75 only in men, which remained significant after adjustment for confounders. Conclusion In hypertensive CKD patients, SUA was correlated with the two indices of arterial stiffness, PWV and AIx@75, with sex-specific variations. However, SUA was associated independently with only AIx@75, but not with PWV, in the entire patient population and only in men. (C) 2014 Wolters Kluwer Health broken vertical bar Lippincott Williams & Wilkins.