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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Stroke
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1496791

Serum Uric Acid/Creatinine Ratio and 1-Year Stroke Recurrence in Patient with Acute Ischemic Stroke and Abnormal Renal Function: results from the Xi ' an Stroke Registry Study of China

Provisionally accepted
Zhongzhong Liu Zhongzhong Liu 1Dandan Zhang Dandan Zhang 1Lingxia Zeng Lingxia Zeng 2Weiyan Guo Weiyan Guo 1Qingli Lu Qingli Lu 1Zhen Lei Zhen Lei 3Yunlong Hao Yunlong Hao 4Pei Liu Pei Liu 1Tong Liu Tong Liu 1Yuxin Wang Yuxin Wang 1Qiaoqiao Chang Qiaoqiao Chang 1Mi Zhang Mi Zhang 1Xuemei Lin Xuemei Lin 1Fang Wang Fang Wang 1Songdi Wu Songdi Wu 1*
  • 1 Xi'an No.1 Hospital, Xi'an, China
  • 2 Department of Epidemiology and Biostatistics, School of Public Health of Xi’an Jiaotong University Health Science Center., Xi’an, China
  • 3 College of Life Science, Northwest University, Xi’an, China
  • 4 School of Medicine, Xizang Minzu University, Xianyang, Shanxi, China

The final, formatted version of the article will be published soon.

    The relationship between abnormal renal function and serum uric acid levels in patients with acute ischemic stroke (AIS) remains insufficiently explored. Although uric acid is associated with cardiovascular and cerebrovascular risk, the specific link between normalized serum uric acid (SUA/SCr) and stroke recurrence in patients with impaired renal function has not been well studied. This study aims to fill this gap by investigating the association between SUA/SCr and 1-year stroke recurrence in patients with AIS and abnormal renal function. Methods: This study utilized the ratio of serum uric acid (SUA) to serum creatinine (SCr) to represent SUA levels normalized for renal function. Abnormal Renal function was defined by the estimated glomerular filtration rate (eGFR)<90 mL/min/1.73 m 2 . Multivariable Cox regression, curve fitting, and stratified analyses were employed to assess the relationship between SUA/SCr and 1-year stroke recurrence in patients with AIS and abnormal renal function, considering SUA/SCr as both a continuous variable and in quartiles (Q1-Q4).Results: Of 1,932 enrolled patients (65.3% male; mean age 66.7 ± 11.3 years), each unit of increase in SUA/SCr was associated with a 17% decrease in 1-year stroke recurrence (HR = 0.83, 95% CI 0.73 to 0.96, P = 0.009). Compared to Q1, the Q2 and Q4 groups showed significantly reduced risk in 1-year stroke recurrence (Q2: HR = 0.46, 95% CI 0.27 to 0.79, P = 0.005; Q4: HR = 0.47, 95% CI 0.27 to 0.81, P = 0.007), with a significant trend across all quartiles (P = 0.01 for trend tests). Curve fitting revealed a negative but non-linear correlation. Subgroup analyses showed that in patients with eGFR< 60 ml/min/1.73 m 2 , Q4 had significantly lower 1-year stroke recurrence risk than Q1 (HR = 0.19, 95% CI 0.04 to 0.86, P = 0.031).Low SUA/SCr independently predicts 1-year stroke recurrence in patients with AIS and abnormal renal function, particularly in those with eGFR < 60 mL/min/1.73 m 2 .

    Keywords: ischemic stroke, Renal function, Stroke recurrence, outcomes Ischemic Stroke, outcomes

    Received: 15 Sep 2024; Accepted: 15 Jan 2025.

    Copyright: © 2025 Liu, Zhang, Zeng, Guo, Lu, Lei, Hao, Liu, Liu, Wang, Chang, Zhang, Lin, Wang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Songdi Wu, Xi'an No.1 Hospital, Xi'an, China

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