title: Serum Uric Acid Exhibits Inverse Relationship with Estimated Glomerular Filtration Rate.
abstract: BACKGROUND
  In this study, we investigated the relationship between serum uric acid (SUA) and renal function in a unique patient cohort wherein SUA levels fluctuate during the course of standard care.
  
  
  METHODS
  Correlation coefficients between SUA and serum creatinine (SCr) and kinetic estimated GFR (KeGFR) were retrospectively investigated in acute myeloid leukemia (AML) patients, and statistically significant and clinically relevant determinants were studied in multiple regression models.
  
  
  RESULTS
  One hundred and twenty-six patients were included in the analysis. Baseline SUA was associated with an increased risk for acute kidney injury (AKI; OR 1.27, 95% CI 1.1-1.5, p = 0.003) and laboratory tumor lysis syndrome (OR 1.26, 95% CI 1.1-1.5, p = 0.005). Prophylactic uric acid-lowering therapy and hydration resulted in lower SUA values from baseline in 88.1% of the patients, the lowest values were observed on post-induction day 1 (20.4% reduction). Significant linear correlations were observed between SUA and SCr (r = 0.35, p < 0.001) values with a significant inverse correlation between SUA and KeGFR on day 1 (r = -0.33, p < 0.001) that persisted through day 4. By subgroup analysis, patients with primary AML (r = -0.49, p < 0.001), baseline SUA >5.5 mg/dl (r = -0.41, p = 0.002) and baseline eGFR >60 ml/min/1.73 m2 (r = -0.51, p < 0.001) demonstrated robust relationships between SUA and KeGFR. The relationship was more robust when the groups were combined (primary AML plus baseline SUA >5.5 mg/dl plus baseline eGFR >60 ml/min/1.73 m2, r = -0.52, p < 0.001).
  
  
  CONCLUSIONS
  The demonstration of linear relationship between SUA and SCr and inverse relationship between SUA and KeGFR reinforces the emerging translational physiological evidence regarding the role of uric acid in AKI.
authors.affiliation: Division of Nephrology, Hypertension and Transplantation, University of Florida, Gainesville, Fla., USA.
authors.forename: Abhilash
authors.initials: A
authors.lastname: Koratala
authors.forename: Girish
authors.initials: G
authors.lastname: Singhania
authors.forename: Kawther F
authors.initials: KF
authors.lastname: Alquadan
authors.forename: Michiko
authors.initials: M
authors.lastname: Shimada
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Johnson
authors.forename: A Ahsan
authors.initials: AA
authors.lastname: Ejaz
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015275:Tumor Lysis Syndrome / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid; D003404:Creatinine