Background: The role of serum uric acid (SUA) after stroke is controversial and can be influenced by renal disease.
Aim: to analyse the role of SUA in the acute phase of stroke based on the presence/absence of kidney disease and cardiovascular outcome.
Methods: Retrospective cohort of a stroke registry followed-up for one year. The sample was divided according to the presence of renal disease defined by haematocrit, urea and gender (HUGE) formula, along with a SUA cut-off point obtained by receiver operating characteristic curves based on SUA levels and on the primary end-point occurrence.
Results: 500 patients (268, 53.6% males) were analysed. Renal disease was present in 14.8% patients. The SUA cut-off for patients with renal disease was 404.46 μmol/L and 344.98 μmol/L for the remainder. Patients with higher SUA levels had decreased neurological disabilities (p = 0.04) and higher comorbidity (p = 0.00). Over a period of 42.3 (19) weeks, a primary end-point occurred in 17.4% patients. In the adjusted Cox model, SUA was associated with the primary end-point (HR 1.45, 95%CI 1.17-1.81, p = 0.01). Separated by the presence/absence of renal disease, SUA levels were associated with the primary endpoint for patients with renal disease (HR 1.29, 95%CI 1.06-1.58, p = 0.01) and for all other patients (HR 1.42, 95%CI 1.2-1.7, p = 0.00).
Conclusions: We observed a relationship between SUA levels and a negative cardiovascular outcome after ischaemic stroke both in patients with and without renal disease, with the worst outcomes occurring in patients with renal insufficiency.
Keywords: Uric acid; chronic kidney disease; ischemic stroke.