Uric acid: a novel risk factor for acute kidney injury in high-risk cardiac surgery patients?
BACKGROUND
Uric acid has been reported to be a risk factor for the development of chronic kidney disease; however, no study has examined whether uric acid may confer a risk for acute kidney injury.


METHODS
We investigated the relation between serum uric acid and the incidence of postoperative acute kidney injury in patients undergoing high-risk cardiovascular surgery (cardiac valve and aneurysm surgery).


RESULTS
Following cardiovascular surgery, 18 of 58 patients (31%) developed acute kidney injury, with 11 of 24 (45.8%) in the elevated uric acid group (defined as >6 mg/dl) and 7 of 34 (20.5%) in the normal uric acid group (p = 0.05). After controlling for baseline renal function, left ventricular ejection fraction, use of nesiritide, type of surgery, and history of previous surgery, an elevated preoperative uric acid conferred a 4-fold risk for acute kidney injury (OR: 3.98, CI: 1.10-14.33, p = 0.035) and longer hospital stay (36.35 vs. 24.66 days, p = 0.009).


CONCLUSIONS
This preliminary study suggests that uric acid may be a novel risk factor for acute kidney injury in patients undergoing high-risk cardiovascular surgery.
Ejaz
A Ahsan
AA
Division of Nephrology, Hypertension and Transplantation, University of Florida, P.O. Box 100224, Gainesville, FL 32610-0224, USA. ejazaa@medicine.ufl.edu
Beaver
Thomas M
TM
Shimada
Michiko
M
Sood
Puneet
P
Lingegowda
Vijaykumar
V
Schold
Jesse D
JD
Kim
Tad
T
Johnson
Richard J
RJ
D058186:Acute Kidney Injury / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D000368:Aged; D000783:Aneurysm / Q000601:surgery; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D045283:Natriuretic Agents / Q000627:therapeutic use; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D011300:Preoperative Care / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain; D014527:Uric Acid