{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T11:04:52Z","timestamp":1783940692883,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Hyperuricemia is highly prevalent in chronic kidney disease (CKD). It has been linked to increased cardiovascular and mortality risk. However, its independent prognostic significance and dose\u2013response relationship with adverse outcomes remain incompletely understood. Methods: This retrospective cohort study included 794 patients with CKD. Hyperuricemia was defined using sex-specific thresholds. The association between hyperuricemia, cardiac events and mortality was tested using a multivariable logistic regression test. Serum uric acid was analyzed as both a categorical and a continuous variable to assess dose\u2013response relationships. Results: Hyperuricemia was present in 44.8% of patients. In multivariable analysis, hyperuricemia was associated with increased odds of cardiac events, although this did not reach statistical significance (OR 1.49, 95% CI 0.98\u20132.27, p = 0.061). However, hyperuricemia independently predicted mortality (OR 1.98, 95% CI 1.04\u20133.78, p = 0.039), and importantly, a dose\u2013response relationship was observed between serum uric acid and adverse outcomes. Each 100 \u03bcmol\/L increase in serum uric acid was associated with a 22% increase in cardiac event risk (OR 1.22, p = 0.011) and a 29% increase in mortality risk (OR 1.29, p = 0.004). Quartile analysis revealed that patients in the highest uric acid quartile had more than three-fold higher mortality compared with the lowest quartile (OR 3.13, 95% CI 1.26\u20137.79, p = 0.014). Conclusions: Hyperuricemia independently predicts mortality and also demonstrates a significant dose\u2013response relationship with adverse outcomes in CKD. The results support serum uric acid as a clinically meaningful biomarker for mortality risk grading in CKD populations.<\/jats:p>","DOI":"10.3390\/jcm15145479","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T09:51:09Z","timestamp":1783936269000},"page":"5479","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum Uric Acid and Mortality Risk in Chronic Kidney Disease: A Dose\u2013Response Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9456-2033","authenticated-orcid":false,"given":"Rasha","family":"Babiker","sequence":"first","affiliation":[{"name":"Department of Physiology, RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Khammas","sequence":"additional","affiliation":[{"name":"Sheikh Khalifa Hospital, Fujairah P.O. Box 3344, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5485-2768","authenticated-orcid":false,"given":"Nada Tawfig","family":"Hashim","sequence":"additional","affiliation":[{"name":"Department of Periodontics, RAK College of Dental Sciences, RAK Medical & Health Sciences University, Ras Al Khaimah 12973, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imran","family":"Rangraze","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9523-4971","authenticated-orcid":false,"given":"Amin S. I.","family":"Banaga","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, National University, Khartoum 11115, Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dania","family":"Elgasim","sequence":"additional","affiliation":[{"name":"RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem Ismail","family":"Nooh","sequence":"additional","affiliation":[{"name":"RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5998-9739","authenticated-orcid":false,"given":"Asmaa A.","family":"Muhammed","sequence":"additional","affiliation":[{"name":"Department of Physiology, RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashfaq Ahmad Shah","family":"Bukhari","sequence":"additional","affiliation":[{"name":"Department of Physiology, RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7195-6945","authenticated-orcid":false,"given":"B. K. Manjunatha","family":"Goud","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"El-Tanani","sequence":"additional","affiliation":[{"name":"RAK College of Pharmacy, RAK Medical and Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4827-8338","authenticated-orcid":false,"given":"Tarig H.","family":"Merghani","sequence":"additional","affiliation":[{"name":"Department of Physiology, RAK College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah P.O. Box 11172, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Naveed","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Fujairah Hospital, Emirates Health Services, Fujairah P.O. Box 10, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"ref_1","first-page":"679","article-title":"Drug-induced hyperuricaemia and gout","volume":"56","author":"Slim","year":"2017","journal-title":"Rheumatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.biochi.2015.06.025","article-title":"Uric acid as a modulator of glucose and lipid metabolism","volume":"116","author":"Lima","year":"2015","journal-title":"Biochimie"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"149","DOI":"10.5606\/ArchRheumatol.2017.6075","article-title":"Prevalence and metabolic factors of hyperuricemia in an elderly agricultural and fishing population in Taiwan","volume":"32","author":"Qian","year":"2017","journal-title":"Arch. 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