Post-operative serum uric acid and acute kidney injury

A. Ahsan Ejaz, Ganesh Kambhampati, Noel I. Ejaz, Bhagwan Dass, Vijay Lapsia, Amir A. Arif, Abdo Asmar, Michiko Shimada, Mourad M. Alsabbagh, Ravi Aiyer, Richard J. Johnson

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

Background: We hypothesized that post-operative serum uric acid (SUA) may be associated with acute kidney injury (AKI). Methods: In this prospective, observational study, the relationships between SUA, urine neutrophil gelatin-ase-associated lipocalin (uNGAL) and interleukin-18 (uIL-18), serum monocyte chemoattractant protein-1 (sMCP-1) and tumor necrosis factor-alpha (sTNF-al-pha), and incidence of AKI were determined. SUA were divided into tertiles and their association with AKI investigated. Results: A total of 100 cardiac surgery patients were included for analyses. The 1 st, 2 nd, and 3 rd SUA tertiles were associated with 15.1%, 11.7%, and 54.5% incidence of AKI, respectively. The 3 rd SUA tertile, compared to the referent 1 st tertile, was associated with an eightfold (OR 8.38, CI 95% 2.13-33.05, p=0.002) increased risk for AKI. Patients with AKI on post-operative day 1 (n=11) were then excluded for the purpose of determining the predictive value of SUA to diagnose AKI on postoperative day 2 and during hospital stay. In comparison to the referent 1 st tertile, the 3 rd tertile SUA was associated with an eightfold increased risk for AKI on post-operative day 2 (adjusted OR 7.94, CI 95% 1.50-42.08, P=.015) and a five-fold increased risk for AKI during hospital stay (OR 4.83, CI 95% 1.21-19.20, P=.025), respectively. SUA (Area Under Curve, AUC 0.77 (CI 95% 0.66-0.88, P<.001), serum creatinine (0.73, CI 95% 0.62-0.84, P<.001) and sTNF-alpha (0.76, CI 95% 0.65-0.87, P<.001) had the best diagnostic performance measured by the Receiver Operating Characteristics curves. Conclusions: We conclude that post-operative SUA is associated with an increased risk for AKI and compares well to conventional markers of AKI.

Original languageEnglish
Pages (from-to)497-505
Number of pages9
JournalJournal of Nephrology
Volume25
Issue number4
DOIs
StatePublished - Jul 2012

Keywords

  • Acute kidney injury
  • Post-operative
  • Uric acid

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