Concentration of serum uric acid in patients with Renal Artery Stenosis and Hypertension prEdict Future nephropathy and death: C‐RASHEF study

Since both serum uric acid (SUA) and renal artery stenosis (RAS) are associated with atherosclerotic events and renal events, it is interesting to investigate whether SUA could predict long‐term outcome in patients with RAS. Patients were enrolled from inpatients from 2010 to 2014, must be ≥40‐year‐old. There were 3269 hypertensive patients enrolled, including 325 RAS patients. Endpoints included all‐cause death and new or worsening nephropathy (NNP). In analysis for all‐cause mortality, associations between SUA and risk of all‐cause mortality were an arising curve in total population, a U‐shape curve in non‐RAS population, and an arising curve in RAS population. When RAS was involved in multivariate analysis, association between SUA and risk of all‐cause mortality was still an arising curve in total population. In analysis for NNP, associations between SUA and risk of NNP were a declining curve in total population, not significant in non‐RAS population, and a U‐shape curve in RAS population. When RAS was involved in multivariate analysis, association between SUA and risk of NNP in total population was no longer significant. Not only association curve of SUA with mortality in non‐RAS patients is different from association curve in RAS patients, but also association curve of SUA with NNP in non‐RAS patients is different from association curve in RAS patients. The authors conclude that mechanisms of uric acid for mortality and NNP in RAS patients are different from non‐RAS patients. In addition to renal vascular obstruction, uric acid is another significant factor for NNP and death in RAS patients.