Predictive Value of Serum Uric Acid/Serum Creatinine Ratio on Cardiovascular and All-Cause Mortality in Patients with Normal Renal Function: an Analysis from the Real Clinical Practice in Italy
Rattachement africain : gb, it, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
ABSTRACT BACKGROUND Serum uric acid (SUA) has been associated with cardiovascular (CV) and all-cause mortality; however, its interpretation is influenced by renal function. The serum uric acid to creatinine ratio (SUA/sCr) has been proposed as a refined marker, integrating urate burden with renal excretory capacity. Evidence from real-world populations with preserved renal function remains limited. METHODS A retrospective observational analysis was performed using administrative and laboratory databases from nine Italian healthcare entities, covering more than 7.6 million individuals. Eligible subjects were 18–95 years old, with estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m², serum creatinine (sCr) ≤1.8 mg/dL, and no prior urate-lowering therapy. The index date was defined as the first SUA measurement between January 2017 and March 2022. A total of 739,950 participants were stratified into quintiles of SUA/sCr ratio. Outcomes were two-year all-cause mortality and CV events, including ischemic heart disease, heart failure, cerebrovascular disease, and coronary revascularization. RESULTS All-cause mortality exhibited a U-shaped distribution, with the lowest risk in mid-quintiles and the highest in extreme quintiles (6.2% in quintile 1, 7.0% in quintile 5). Cardiovascular events showed a progressive increase, from 9.9% in quintile 1 to 11.6% in quintile 5. Sex-stratified analyses indicated higher absolute risks in men, whereas women demonstrated steeper relative increases across higher quintiles. In individuals with hyperuricemia, mortality and CV events rose consistently with increasing SUA/sCr values. CONCLUSIONS The SUA/sCr ratio is an independent predictor of short-term mortality and cardiovascular events in individuals with preserved renal function. Its incorporation into routine risk stratification may support earlier identification of high-risk patients, particularly those with elevated SUA. CLINICAL PERSPECTIVE What Is New? In this large, real-world study of nearly 740,000 adults with preserved renal function, the serum uric acid to serum creatinine (SUA/sCr) ratio emerged as a strong, independent predictor of two-year all-cause and cardiovascular mortality. The prognostic value of SUA/sCr was particularly evident in patients with hyperuricemia, where higher quintiles were associated with progressively increased risk of death and cardiovascular events. What Are the Clinical Implications? The SUA/sCr ratio, based on two inexpensive and widely available laboratory parameters, provides a practical tool for early cardiovascular risk stratification in patients without overt kidney disease.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Predictive Value of Serum Uric Acid/Serum Creatinine Ratio on Cardiovascular and All-Cause Mortality in Patients with Normal Renal Function: an Analysis from the Real Clinical Practice in Italy
- Date Crossref
- 15/12/2025
- Éditeur
- openRxiv
- Type
- posted-content
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Health Economics and Outcomes Research (United Kingdom) pays non établi dans la noticeEntreprise
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AULSS 2 Marca Trevigiana pays non établi dans la noticeÉtablissement de santé
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Azienda ULSS 8 Berica pays non établi dans la noticeÉtablissement de santé
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Ospedale A. Perrino pays non établi dans la noticeÉtablissement de santé
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Association for Symbolic Logic pays non établi dans la noticeInstitution
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ASL Roma pays non établi dans la noticeOrganisme public
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Azienda Sanitaria Locale Salerno pays non établi dans la noticeÉtablissement de santé
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University of Molise pays non établi dans la noticeUniversité ou école supérieure
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Regione Puglia pays non établi dans la noticeOrganisme public
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Regione Molise pays non établi dans la noticeOrganisme public
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University of Bologna pays non établi dans la noticeUniversité ou école supérieure
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CliCon S.r.l. pays non établi dans la noticeInstitution
Health Economics and Outcomes Research (United Kingdom), AULSS 2 Marca Trevigiana et Azienda ULSS 8 Berica, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.