Uric Acid is a Useful Tool to Predict Contrast-Induced Nephropathy

Abstract

Developing contrast-induced nephropathy (CIN) after primary percutaneous coronary intervention (pPCI) has a negative impact on survival and morbidity. We assessed the predictive value of serum uric acid (SUA) for the development of CIN in patients with ST-segment elevation myocardial infarction (STEMI) who underwent pPCI. Contrast-induced nephropathy was defined an increase of ≥25% or ≥0.5 mg/dL in creatinine concentrations within 72 hours after pPCI. Patients were divided into 2 groups according to admission median SUA level. Serum uric acid level was <5.4 mg/dL (group 1; n = 222) and ≥5.4 mg/dL (group 2; n = 228). Compared to group 1, development of CIN (12% vs 20%, P < .001) was significantly greater in group 2. Using a cut point of >5.45 mg/dL, the SUA level predicted development of CIN with a sensitivity of 70% and specificity of 67%. In multiple logistic regression analysis, SUA level, diabetes mellitus, left ventricular ejection fraction <50%, contrast volume, estimated glomerular filtration rate, and C-reactive protein level emerged as independent predictors of CIN. In conclusion, elevated SUA is an independent risk factor for the development of CIN after pPCI in patients with STEMI.

Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: A review

“…The risk of AKI was 16% higher with each 1 mg increase in SUA [128]. SUA level is a significant predictor of contrast-induced nephropathy (CIN) [129], [130]. UA lowering with allopurinol in addition to saline hydration was associated with significantly lower incidence of CIN compared to saline hydration alone or saline hydration plus N-acetyl cysteine [130].…”

Serum uric acid and acute kidney injury: A mini review

“…Interestingly, radiocontrast causes an acute uricosuria [41], [46] that may potentially play a role in injury. Indeed, an elevation in serum uric acid, even at modest levels, is known to increase the risk for contrast-induced AKI [47], [48]. A recent meta-analysis by Kanbay et al that included 10 studies reported that elevated levels of serum uric acid were associated with a twofold increased risk for the development of radiocontrast-induced AKI (pooled odds ratio 2.03; 95%CI 1.48–2.78) [49].…”

Elevation in serum uric acid levels predicts favourable response to erlotinib treatment in patients with metastatic non‐small‐cell lung cancer

“…11 Recently, uric acid has been a key area of focus as a potential causal factor in a multitude of diseases including but not limited to hypertension, nephropathy, atherosclerosis, heart failure and acute kidney injury. [12][13][14][15][16][17][18] The common pathophysiologic denominator of these pathways is thought to be oxidative stress and inflammation resulting from a hyperuricemic state. 19 In vitro studies demonstrated that the pro-oxidative and pro-inflammatory state induced by hyperuricemia leads to microvascular dysfunction through stimulation of vascular smooth muscle cell proliferation, inhibition of endothelial cell function and activation of renin-angiotensin system.…”