title: Hyperuricemia as a risk factor for contrast-induced nephropathy in patients with chronic kidney disease.
abstract: 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.
authors.affiliation: Department of Medicine, Division of Nephrology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2372, USA. info@omertoprak.com
authors.forename: Omer
authors.initials: O
authors.lastname: Toprak
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cirit
authors.forename: Ertap
authors.initials: E
authors.lastname: Esi
authors.forename: Nursen
authors.initials: N
authors.lastname: Postaci
authors.forename: Murat
authors.initials: M
authors.lastname: Yesil
authors.forename: Serdar
authors.initials: S
authors.lastname: Bayata
mesh_terms: 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
chemical_list: D003287:Contrast Media; D003404:Creatinine