Hyperuricemia is associated with acute kidney injury and all‐cause mortality in hospitalized patients

Kang, Min Woo; Chin, Ho Jun; Joo, Kwon Wook; Na, Ki Young; Kim, Sejoong; Han, Seung Seok

doi:10.1111/nep.13559

Cited by 23 publications

(14 citation statements)

References 43 publications

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“…Additionally, there is evidence that higher uric acid levels can induce AKI through broblast expansion, the in ammatory cascade and an increase in endothelin-1 [26,27]. Similar to previous investigations, our research found that hyperuricaemia prior to surgery was a risk factor for postoperative AKI [28,29].…”

Section: Discussionsupporting

confidence: 89%

Prediction Scores for Acute Kidney Injury following Adult Cardiac Surgery

Tian

Zhao

Wang

et al. 2020

Preprint

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Background In the development of scoring systems for acute kidney injury (AKI) following cardiac surgery, previous investigations have primarily and solely attached importance to preoperative associated risk factors without any consideration for surgery-derived physiopathology. We sought to internally derive and then validate risk score systems using pre- and intraoperative variables to predict the occurrence of any-stage (stage 1-3) and stage-3 AKI within 7 days.Methods Patients undergoing cardiac surgery from Jan 1, 2012, to Jan 1, 2019, were enrolled in our retrospective study. The clinical data were divided into a derivation cohort (n= 43799) and a validation cohort (n= 14600). Multivariable logistic regression analysis was used to develop the prediction models.Results The overall prevalence of any-stage and stage-3 AKI after cardiac surgery was 34.3% and 1.7%, respectively. Any-stage AKI prediction-model discrimination measured by the area under the curve (AUC) was acceptable (AUC = 0.69, 95% CI: 0.68, 0.69), and the prediction model calibration measured by the Hosmer-Lemshow test was good (P = 0.95). The stage-3 AKI prediction model had an AUC of 0.84 (95% CI 0.83, 0.85) and good calibration according to the Hosmer-Lemshow test (P = 0.73).Conclusions Using pre- and intraoperative data, we developed two scoring systems for any-stage AKI and stage-3 AKI in a cardiac surgery population. These scoring systems can potentially be adopted clinically in the field of AKI recognition and therapeutic intervention.

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Section: Discussionsupporting

confidence: 89%

Prediction Scores for Acute Kidney Injury following Adult Cardiac Surgery

Tian

Zhao

Wang

et al. 2020

Preprint

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“…This is consistent with the following research results. It has been reported that hyperuricemia increases the risks of AKI and all-cause mortality in hospitalized patients 48 . Study had found that there was a significant statistical association between serum uric acid levels and all-cause mortality in people with type 2 diabetes 49 .…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of hyperuricemia for patients with sepsis in the intensive care unit

Liu

Zhong

Liu

2022

Sci Rep

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This study evaluated the relationship between hyperuricemia at admission and the clinical prognosis of patients with sepsis. The data were obtained from the Intensive Care Medical Information Database III. The patients were divided into a normal serum uric acid group and a hyperuricemia group. The main outcome was 90-day mortality, and the secondary outcomes were hospital mortality, 30-day mortality, and acute kidney injury. Propensity score matching was used to balance the baseline characteristics of the groups. Our study retrospectively included 954 patients. Before and after propensity score matching, the incidence of AKI, the 30-day and 90-day mortality rates were significantly higher in the hyperuricemia group. Cox regression analysis showed that hyperuricemia was significantly associated with 90-day mortality (HR 1.648, 95% CI 1.215–2.234, p = 0.006), and hyperuricemia was significantly associated with the incidence of AKI (HR 1.773, 95% CI 1.107–2.841, p = 0.017). The Kaplan–Meier survival curve showed that the 90-day survival rate was significantly lower in the hyperuricemia group. In patients with sepsis in the intensive care unit, hyperuricemia was significantly associated with increased risk 90-day all-cause mortality and the incidence of AKI.

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“…Open access hyperuricaemia is an independent risk factor for CSA-AKI. [8][9][10] A meta-analysis including 18 cohort studies with 75 200 patients found that patients with hyperuricaemia have a significantly higher risk of AKI compared with the control group (OR 2.24, 95% CI 1.76 to 2.86; p<0.01). The mechanism of AKI caused by hyperuricaemia is related to the crystallisation of uric acid, which may also activate an epithelial-mesenchymal proinflammatory response.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Effects of hyperuricaemia, with the superposition of being overweight and hyperlipidaemia, on the incidence of acute kidney injury following cardiac surgery: a retrospective cohort study

Yang

et al. 2022

BMJ Open

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ObjectivesAcute kidney injury (AKI) is a common complication of cardiac surgery. This study aimed to explore the effects of hyperuricaemia, being overweight and hyperlipidaemia as risk factors for AKI in patients following cardiac surgery (cardiac surgery-associated acute kidney injury (CSA-AKI)).DesignRetrospective observational study.SettingUniversity teaching, grade-A tertiary hospital in Shanghai, China.ParticipantsPatients who underwent cardiac surgery from July 2015 to December 2015 in Zhongshan Hospital, Fudan University.Main outcome measuresWe investigated the effect of hyperuricaemia, in combination with being overweight and hyperlipidaemia, on the risk of CSA-AKI.ResultsA total of 1420 patients were enrolled. The AKI incidence in the highest uric acid group was 44.4%, while that in the lowest uric acid group was 28.5% (p<0.001). Patients in the higher uric acid quartiles were more likely to be overweight and hyperlipidaemic at the same time (p<0.001). Multivariate logistic regression analysis showed that hyperuricaemia was an independent risk factor for AKI (OR=1.237, 95% CI 1.095 to 1.885; p=0.009); being overweight or hyperlipidaemia alone was not an independent risk factor, but the combination of being overweight and hyperlipidaemia was (OR=1.544, 95% CI 1.059 to 2.252; p=0.024). In the final model, the OR value increased to 3.126 when hyperuricaemia was combined with being overweight and hyperlipidaemia, and the Hosmer-Lemeshow test showed that all three models fit well (p=0.433, 0.638 and 0.597, respectively).ConclusionsThe combination of being overweight and having hyperlipidaemia was an independent risk factor, but being overweight or having hyperlipidaemia alone was not. The combination of hyperuricaemia, being overweight and hyperlipidaemia further increased the risk of CSA-AKI.

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Hyperuricemia is associated with acute kidney injury and all‐cause mortality in hospitalized patients

Cited by 23 publications

References 43 publications

Prediction Scores for Acute Kidney Injury following Adult Cardiac Surgery

Prediction Scores for Acute Kidney Injury following Adult Cardiac Surgery

Prognostic value of hyperuricemia for patients with sepsis in the intensive care unit

Effects of hyperuricaemia, with the superposition of being overweight and hyperlipidaemia, on the incidence of acute kidney injury following cardiac surgery: a retrospective cohort study

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