Kyoung-Woon Joung1, Jun-Young Jo1, Wook-Jong Kim1, Dae-Kee Choi1, Ji-Hyun Chin1, Eun-Ho Lee2, In-Cheol Choi1. 1. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: leho@naver.com.
Abstract
OBJECTIVE: Recent studies suggested that elevated serum uric acid levels may be associated with the risk of acute kidney injury (AKI) in several settings. However, the effect of uric acid on the risk of AKI after cardiovascular surgery remains uncertain. DESIGN: A retrospective analysis. SETTING: A tertiary care university hospital. PARTICIPANTS: All consecutive adult patients (n = 1,019) who underwent cardiovascular surgery between January 2011 and May 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Preoperative and perioperative data were assessed in the study population. AKI was defined and staged as serum creatinine concentration-based Acute Kidney Injury Network criteria. Univariate and multivariate logistic regression analyses were conducted to evaluate the association between preoperative uric acid and postoperative AKI. Preoperative elevated uric acid (≥ 6.5 mg/dL) was associated independently with AKI after cardiovascular surgery (odds ratio 1.46; 95% confidence interval 1.04-2.06, p = 0.030). Results were the same in subgroup analyses. Preoperative elevated uric acid (≥ 6.5 mg/dL) also was associated with a higher incidence of prolonged ICU and hospital stay. CONCLUSIONS: Preoperative elevated serum uric acid is an independent risk factor for AKI in patients undergoing cardiovascular surgery. This finding suggests that preoperative measurements of serum uric acid concentration may help stratify risks for AKI in these patients.
OBJECTIVE: Recent studies suggested that elevated serum uric acid levels may be associated with the risk of acute kidney injury (AKI) in several settings. However, the effect of uric acid on the risk of AKI after cardiovascular surgery remains uncertain. DESIGN: A retrospective analysis. SETTING: A tertiary care university hospital. PARTICIPANTS: All consecutive adult patients (n = 1,019) who underwent cardiovascular surgery between January 2011 and May 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Preoperative and perioperative data were assessed in the study population. AKI was defined and staged as serum creatinine concentration-based Acute Kidney Injury Network criteria. Univariate and multivariate logistic regression analyses were conducted to evaluate the association between preoperative uric acid and postoperative AKI. Preoperative elevated uric acid (≥ 6.5 mg/dL) was associated independently with AKI after cardiovascular surgery (odds ratio 1.46; 95% confidence interval 1.04-2.06, p = 0.030). Results were the same in subgroup analyses. Preoperative elevated uric acid (≥ 6.5 mg/dL) also was associated with a higher incidence of prolonged ICU and hospital stay. CONCLUSIONS: Preoperative elevated serum uric acid is an independent risk factor for AKI in patients undergoing cardiovascular surgery. This finding suggests that preoperative measurements of serum uric acid concentration may help stratify risks for AKI in these patients.
Authors: Hans U Gerth; Michele Pohlen; Dennis Görlich; Gerold Thölking; Martin Kropff; Wolfgang E Berdel; Hermann Pavenstädt; Marcus Brand; Philipp Kümpers Journal: PLoS One Date: 2016-05-06 Impact factor: 3.240