Altered Mineral Metabolism, Serum Uric Acid to Creatinine Ratio and Atherogenic Index of Plasma as Cardiovascular Risk Predictors in Chronic Kidney Disease: A Cross-sectional Study

Introduction: Chronic Kidney Disease (CKD) is a significant public health issue associated with increased cardiovascular morbidity. Mineral metabolism imbalance and dyslipidaemia exacerbate Vascular Calcification (VC) and cardiac dysfunction. Serum Uric Acid to Creatinine Ratio (UACR) and Atherogenic Index of Plasma (AIP) have been explored as biomarkers for cardiovascular risk in CKD; however, limited data is available in this regard. Aim: The study aimed to evaluate the utility of UACR and AIP as cardiovascular risk factor and also to study the correlation of CKD stages with UACR, AIP, lipid profiles, and mineral metabolism in CKD patients. Materials and Methods: A cross-sectional study was conducted from December 2013 to June 2016 at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India. The study included 50 CKD patients and 50 healthy controls. CKD diagnosis was confirmed using Kidney Disease: Improving Global Outcomes (KIDGO) criteria. Participants included adults aged 18-70 years with confirmed CKD stages 3-5 who provided informed consent. Data on demographics, serum uric acid, creatinine, lipid profiles, calcium, and phosphate levels were collected. UACR and AIP were calculated. Statistical analyses—including Independent t-tests, Chi-square tests, and Pearson correlation analyses—were performed, with a statistical significance of p-value <0.05. Results: The mean age of CKD patients was 47.74±11.01 years, with a male predominance (62%). From Stage 3 to Stage 5 CKD, lipid profiles deteriorated significantly with TC/HDL-C ratio increasing from 3.45 to 4.05 (p-value <0.001) and TG/HDL-C from 2.55 to 5.55 (r-value=0.70, p-value <0.001). AIP increased from 0.04 to 0.26 (p-value <0.001), while UACR showed negative correlation (r-value=-0.30, p-value=0.05) with lipid parameters. Calcium-phosphorus product showed a strong correlation with CKD progression (r-value=0.62, p-value <0.001). Renal function declined with elevated blood urea (119.88 to 190.45 mg/dL, p-value <0.001) and creatinine levels (7.04 to 10.76 mg/dL, p-value <0.001). Conclusion: UACR and AIP are effective predictors of cardiovascular risk in CKD patients, correlating with dyslipidaemia and declining renal function. These findings support their use in risk stratification and management in CKD care.