Uric acid: a novel risk factor for acute kidney injury in high-risk cardiac surgery patients?

Am J Nephrol. 2009;30(5):425-9. doi: 10.1159/000238824. Epub 2009 Sep 11.

Abstract

Background: Uric acid has been reported to be a risk factor for the development of chronic kidney disease; however, no study has examined whether uric acid may confer a risk for acute kidney injury.

Methods: We investigated the relation between serum uric acid and the incidence of postoperative acute kidney injury in patients undergoing high-risk cardiovascular surgery (cardiac valve and aneurysm surgery).

Results: Following cardiovascular surgery, 18 of 58 patients (31%) developed acute kidney injury, with 11 of 24 (45.8%) in the elevated uric acid group (defined as >6 mg/dl) and 7 of 34 (20.5%) in the normal uric acid group (p = 0.05). After controlling for baseline renal function, left ventricular ejection fraction, use of nesiritide, type of surgery, and history of previous surgery, an elevated preoperative uric acid conferred a 4-fold risk for acute kidney injury (OR: 3.98, CI: 1.10-14.33, p = 0.035) and longer hospital stay (36.35 vs. 24.66 days, p = 0.009).

Conclusion: This preliminary study suggests that uric acid may be a novel risk factor for acute kidney injury in patients undergoing high-risk cardiovascular surgery.

Trial registration: ClinicalTrials.gov NCT00110201.

MeSH terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / epidemiology*
  • Acute Kidney Injury / prevention & control
  • Aged
  • Aneurysm / surgery
  • Cardiovascular Surgical Procedures / adverse effects*
  • Cardiovascular Surgical Procedures / statistics & numerical data*
  • Female
  • Heart Valve Diseases / surgery
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Natriuretic Agents / therapeutic use
  • Natriuretic Peptide, Brain / therapeutic use
  • Postoperative Complications / blood
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control
  • Preoperative Care / statistics & numerical data
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Risk Factors
  • Uric Acid / blood*

Substances

  • Natriuretic Agents
  • Natriuretic Peptide, Brain
  • Uric Acid

Associated data

  • ClinicalTrials.gov/NCT00110201