Hyperuricemia and contrast-induced acute kidney injury: A systematic review and meta-analysis.
BACKGROUND
Hyperuricemia may be associated with an increased risk of contrast-induced acute kidney injury (CI-AKI). In recent years, studies about the relationship between them gradually appeared. We performed a systematic review and meta-analysis to investigate whether hyperuricemia is an independent risk factor for CI-AKI.


METHODS
Relevant studies were searched in PubMed, Embase, Cochrane Library, and CBM (Chinese Biomedical Literature database) databases until April 18, 2016, without language restriction. Observational studies evaluating serum uric acid (SUA) levels and CI-AKI risks were included. The pooled odds ratio was calculated to assess the association between hyperuricemia and risk of CI-AKI using a random-effects model.


RESULTS
Eighteen relevant studies involving a total of 13,084 patients met our inclusion criteria. Presence of hyperuricemia was associated with an increased risk of CI-AKI development regardless of whether the effect size was adjusted or not (unadjusted OR: 2.08, 95% CI: 1.63-2.64; adjusted OR: 1.68, 95% CI: 1.38-2.04). In-hospital mortality and cases of renal replacement therapy were significantly different between subjects with hyperuricemia and normouricemia undergoing coronary angiography (CAG) and/or percutaneous coronary intervention (PCI).


CONCLUSIONS
Hyperuricemia is independently associated with the occurrence of CI-AKI and it significantly increases the in-hospital mortality and the risk of renal replacement therapy among the patients after CAG and/or PCI. Future research is needed to determine whether urate-lowering therapy has beneficial effects for reducing the incidence of CI-AKI and in-hospital adverse events.
Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, The 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China; The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, China. Electronic address: leftsky410@163.com.
Tian
T
Zuo
The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, China. Electronic address: 13710314997@163.com.
Lu
L
Jiang
Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, The 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China. Electronic address: maoshuaitcm@163.com.
Shuai
S
Mao
Department of Cardiology, Yichang Hospital of Chinese Medicine, Clinical Medical College of Chinese Medicine, China Three Gorges University, Yichang 443000, China. Electronic address: liuxuehui0928@sina.cn.
Xuehui
X
Liu
Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, The 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China. Electronic address: yinxingzy@yeah.com.
Xin
X
Yin
Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, The 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China; The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, China. Electronic address: guolh5946@163.com.
Liheng
L
Guo
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects / Q000639:trends; D006801:Humans; D033461:Hyperuricemia / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012307:Risk Factors
D003287:Contrast Media
Contrast-induced acute kidney injury; Hyperuricemia; Meta-analysis