Hyperuricemia as a risk factor for contrast-induced nephropathy in patients with chronic kidney disease.
OBJECTIVE
Hyperuricemia as a risk factor for contrast-induced nephropathy (CIN) has not been studied.


BACKGROUND
The aim of the present study was to assess the influence of hyperuricemia on the development of CIN in patients undergoing coronary angiography.


METHODS
This was a prospective cohort study. A total of 266 patients with a mean age of 58.33 +/- 7.85 years and serum creatinine > or = 1.2 mg/dl were divided into two groups (hyperuricemic, n = 126, and normouricemic, n = 140). CIN was defined as an increase of > or = 25% in creatinine over baseline within 48 hr of angiography, and hyperuricemia as serum uric acid > or = 7 mg/dl in males and > or = 6.5 mg/dl in females.


RESULTS
CIN occurred in 15.1% of the hyperuricemic group and 2.9% of the normouricemic group (P < 0.001). Serum creatinine increased from 1.45 +/- 0.20 to 1.67 +/- 0.45 mg/dl in the hyperuricemic group and from 1.42 +/- 0.16 to 1.56 +/- 0.23 mg/dl in the normouricemic group (P < 0.001). Hyperuricemia [odds ratio (OR) 4.71; 95% confidence interval (95% CI) 1.29-17.21; P = 0.019] and a high incidence of multi-vessel coronary involvement (OR 3.59; 95% CI 1.12-11.48; P = 0.032) in the hyperuricemic group were predictors of CIN. Hypoalbuminemia (P = 0.001) and age > or = 70 years (P = 0.023) were other risk indicators of CIN. Length of hospital stay (P < 0.001) and CIN requiring renal replacement therapy (P = 0.017) were significantly higher in hyperuricemic group. Serum uric acid level > or = 7 mg/dl in males and > or = 5.9 mg/dl in females were found to be the best cut-off value for prediction of CIN.


CONCLUSIONS
Our data support the hypothesis that patients with hyperuricemia are at risk of developing CIN.
Toprak
Omer
O
Department of Medicine, Division of Nephrology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2372, USA. info@omertoprak.com
Cirit
Mustafa
M
Esi
Ertap
E
Postaci
Nursen
N
Yesil
Murat
M
Bayata
Serdar
S
D016009:Chi-Square Distribution; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D033461:Hyperuricemia / Q000150:complications*; D007674:Kidney Diseases / Q000139:chemically induced*; D007676:Kidney Failure, Chronic / Q000150:complications*; D007677:Kidney Function Tests; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors
D003287:Contrast Media; D003404:Creatinine