Abstract: Objective　To investigate the effect of serum uric acid (SUA) on prognosis of patients with maintenance hemodialysis (MHD) complicated with mineral metabolism disorder. Methods　A total of 192 patients with MHD complicated with mineral metabolism disorder were selected. According to the level of SUA, patients were divided into the group Q1 (SUA≤363 μmol/L, n=47), the group Q2 (SUA 364-459 μmol/L, n=48), the group Q3 (SUA 460-559 μmol/L, n=49) and the group Q4 (SUA≥560 μmol/L, n=48). The clinical data were compared between the 4 groups. Patients were followed up. Spearman method was used to analyze the correlation between SUA and other index. Kaplan-Meier method was used to compare the survival rates of the 4 groups, and Cox regression model was used to analyze the effect of SUA on the prognosis of the patients. Results　Compared with the group Q1, serum creatinine (Scr), urea nitrogen (BUN) and blood phosphorus (P) were increased in the groups Q2, Q3 and Q4, glomerular filtration rate (eGFR) and high density lipoprotein (HDL-C) were decreased, and albumin (ALB) was increased in the groups Q2 and Q4 (P＜0.05). Compared with the groups Q2 and Q3, the levels of Scr, BUN and P were decreased in the group Q4 (P＜0.05). SUA was positively correlated with ALB, BUN, Scr, P, and magnesium (Mg), and negatively correlated with calcium (Ca) (P＜0.05). The mean follow-up time was 16.0 (11.0, 23.8) months. A total of 45 patients (23.4%) had outcome events, including 22 patients (11.5%) with cardiovascular death. Kaplan-Meier survival curve showed that the all-cause mortality and cardiovascular disease mortality were higher in the group Q1 (Log-rank χ2=9.707 and 7.912, P＜0.05). Univariate Cox regression analysis showed that low ALB, low blood Mg, and CVD were risk factors for cardiovascular disease death in MHD patients with mineral metabolism disorder, while higher uric acid (the Q4 groups) was its protective factor (P＜0.05). Multivariate Cox regression analysis showed that advanced age, low blood Mg and cardiovascular disease were independent risk factors for all-cause death in MHD patients with mineral metabolism disorder, while higher uric acid (the groups Q3,Q4) was its protective factor (P＜0.05). Conclusion　Higher SUA can reduce all-cause mortality in MHD patients with mineral metabolism disorders.

Key words: renal dialysis, minerals, metabolic diseases, prognosis, uric acid, maintenance hemodialysis