Title

Post-Operative Serum Uric Acid And Acute Kidney Injury

Keywords

Acute kidney injury; Post-operative; Uric acid

Abstract

Background: We hypothesized that post-operative serum uric acid (SUA) may be associated with acute kidney injury (AKI). Methods: In this prospective, observational study, the relationships between SUA, urine neutrophil gelatin-ase-associated lipocalin (uNGAL) and interleukin-18 (uIL-18), serum monocyte chemoattractant protein-1 (sMCP-1) and tumor necrosis factor-alpha (sTNF-al-pha), and incidence of AKI were determined. SUA were divided into tertiles and their association with AKI investigated. Results: A total of 100 cardiac surgery patients were included for analyses. The 1 st, 2 nd, and 3 rd SUA tertiles were associated with 15.1%, 11.7%, and 54.5% incidence of AKI, respectively. The 3 rd SUA tertile, compared to the referent 1 st tertile, was associated with an eightfold (OR 8.38, CI 95% 2.13-33.05, p=0.002) increased risk for AKI. Patients with AKI on post-operative day 1 (n=11) were then excluded for the purpose of determining the predictive value of SUA to diagnose AKI on postoperative day 2 and during hospital stay. In comparison to the referent 1 st tertile, the 3 rd tertile SUA was associated with an eightfold increased risk for AKI on post-operative day 2 (adjusted OR 7.94, CI 95% 1.50-42.08, P=.015) and a five-fold increased risk for AKI during hospital stay (OR 4.83, CI 95% 1.21-19.20, P=.025), respectively. SUA (Area Under Curve, AUC 0.77 (CI 95% 0.66-0.88, P<.001), serum creatinine (0.73, CI 95% 0.62-0.84, P<.001) and sTNF-alpha (0.76, CI 95% 0.65-0.87, P<.001) had the best diagnostic performance measured by the Receiver Operating Characteristics curves. Conclusions: We conclude that post-operative SUA is associated with an increased risk for AKI and compares well to conventional markers of AKI. © 2012 Società Italiana di Nefrologia.

Publication Date

7-1-2012

Publication Title

Journal of Nephrology

Volume

25

Issue

4

Number of Pages

497-505

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.5301/jn.5000173

Socpus ID

84863964767 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/84863964767

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