title: Uric acid levels correlate with baseline renal function and high levels are a potent risk factor for postoperative chronic kidney disease in patients with renal cell carcinoma.
abstract: OBJECTIVE
  We investigated the relationship between preoperative uric acid and the glomerular filtration rate preoperatively and postoperatively in patients with renal cell carcinoma.
  
  
  METHODS
  Included in study were 1,534 patients who underwent radical or partial nephrectomy for renal cell carcinoma between 1994 and 2008. Uric acid was measured preoperatively. The estimated glomerular filtration rate was calculated using the MDRD (Modification of Diet in Renal Disease) equation preoperatively and postoperatively within 7 days, and at 3 months, and 1 and 3 years. We looked for correlations of uric acid with the glomerular filtration rate, patient demographics and comorbidities. We also evaluated the predictive value of uric acid for the preoperative glomerular filtration rate and new onset chronic kidney disease, defined as a glomerular filtration rate of less than 60 ml/minute/1.73 m(2), after nephrectomy using multivariate regression analysis.
  
  
  RESULTS
  Mean ± SD uric acid was 5.2 ± 1.5 mg/dl (range 1.3 to 11.3). Mean preoperative uric acid correlated with the preoperative glomerular filtration rate (r = -0.313, p <0.001) and was associated with prevalent chronic kidney disease. On multivariate regression analysis a decreased preoperative glomerular filtration rate correlated significantly with earlier year of surgery, older age, male gender, hypertension, high uric acid and larger tumors (each p <0.001). Hypertension, male gender and high body mass index correlated with high uric acid (each p <0.001). Older age (p <0.001), diabetes mellitus (p = 0.002), low preoperative glomerular filtration rate (p <0.001) and high preoperative uric acid (p = 0.002) were significant predictors of new onset chronic kidney disease 3 years after nephrectomy.
  
  
  CONCLUSIONS
  Increased preoperative uric acid was an independent predictor of a low preoperative glomerular filtration rate and new onset chronic kidney disease in patients with renal cell carcinoma who underwent nephrectomy.
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. besthml@medimail.co.kr
authors.forename: Hwang Gyun
authors.initials: HG
authors.lastname: Jeon
authors.forename: Seol Ho
authors.initials: SH
authors.lastname: Choo
authors.forename: Byong Chang
authors.initials: BC
authors.lastname: Jeong
authors.forename: Seong Il
authors.initials: SI
authors.lastname: Seo
authors.forename: Seong Soo
authors.initials: SS
authors.lastname: Jeon
authors.forename: Han Yong
authors.initials: HY
authors.lastname: Choi
authors.forename: Hyun Moo
authors.initials: HM
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000097:blood* / Q000601:surgery*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000097:blood* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
chemical_list: D014527:Uric Acid