{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:04:38Z","timestamp":1789538678449,"version":"build-2803163510"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Inroduction<\/jats:title>\n                    <jats:p>Within-person variation in serum uric acid (SUA) may reflect clinical instability, but its association with outcomes in chronic kidney disease (CKD) is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied 10,556 adults with EHR-defined CKD and at least three SUA measurements during a 365-day baseline window across a nine-hospital consortium. Variability was quantified primarily by the coefficient of variation (CV); the primary outcome was all-cause mortality, and secondary outcomes were a composite kidney endpoint and major adverse cardiovascular events (MACE). Cox models adjusted for demographics, comorbidities, baseline laboratory values, mean SUA, measurement number and medication use. Reproducibility of the short-term mortality association was assessed in MIMIC-IV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During a median follow-up of 0.62 years, 649 deaths, 676 kidney events and 3,172 first MACE occurred. Higher SUA CV was associated with mortality in the fully adjusted model (hazard ratio [HR] per 1-SD increase 1.24, 95% CI 1.15\u20131.32; highest versus lowest tertile 1.87, 95% CI 1.50\u20132.33), whereas adjusted associations with kidney events (HR 1.01, 95% CI 0.93\u20131.10) and MACE (HR 1.02, 95% CI 0.98\u20131.05) were null. Of all deaths, 495 (76.3%) occurred within 90 days. In a post-90-day landmark analysis of 6,784 participants with more than 90 days of follow-up, the mortality association was not observed (154 deaths; HR 1.02, 95% CI 0.86\u20131.21). Results were similar after daily aggregation of SUA measurements and additional adjustment for urate-lowering therapy, colchicine and sodium-glucose cotransporter-2 inhibitors. In MIMIC-IV (\n                      <jats:italic>n<\/jats:italic>\n                      = 5,350; 931 deaths within 90 days), the adjusted HR per 1-SD increase in CV was 1.32 (95% CI 1.26\u20131.38).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Greater SUA variability was associated with mortality during short follow-up; the concentration of deaths within 90 days and the null post-90-day landmark estimate suggest that the exposure may primarily mark near-term clinical deterioration rather than a causal or durable long-term prognostic mechanism.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1919779","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:31:01Z","timestamp":1789536661000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum uric acid variability and short-term mortality in chronic kidney disease: a retrospective cohort study with independent replication in MIMIC-IV"],"prefix":"10.3389","volume":"13","author":[{"given":"Fan","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, Hubei, China"]},{"name":"Key Laboratory for Molecular Diagnosis of Hubei Province, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyuan","family":"Gan","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, Hubei, China"]},{"name":"Key Laboratory for Molecular Diagnosis of Hubei Province, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenli","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, Hubei, China"]},{"name":"Key Laboratory for Molecular Diagnosis of Hubei Province, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, Hubei, China"]},{"name":"Department of Nutrition, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingruo","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, Hubei, China"]},{"name":"Key Laboratory for Molecular Diagnosis of Hubei Province, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"Clinical practice guideline for the evaluation and management of chronic 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