Scientific publications

Uric Acid and acute kidney injury in high-risk patients for developing Acute Kidney Injury undergoing cardiac surgery: a prospective multicenter study

May 2, 2024 | Magazine: Revista Española de Anestesiología y Reanimación

D Nagore  1 , A Candela  2 , M Bürge  3 , E Tamayo  4 , M Murie-Fernández  5 , M Vives  6 , P Monedero  7 , J Álvarez  8 , E Mendez  9 , A Pasqualetto  9 , T Mon  9 , R Pita  10 , M A Varela  10 , C Esteva  10 , M A Pereira  10 , J Sanchez  11 , M A Rodriguez  11 , A Garcia  12 , P Carmona  13 , M López  13 , A Pajares  13 , R Vicente  13 , R Aparicio  13 , I Gragera  14 , E Calderón  15 , J M Marcos  16 , L Gómez  17 , J M Rodríguez  18 , A Matilla  18 , A Medina  19 , A Hernández  20 , L Morales  21 , L Santana  21 , E Garcia  22 , S Montesinos  23 , P Muñoz  24 , B Bravo  25 , Julian Alvarez  26 , V Blanco  27 ; en nombre del Grupo Español de Investigación en Cirugía Cardiaca Perioperatoria


Purpose: It is unclear whether preoperative serum uric acid (SUA) elevation may play a role in the development of acute kidney injury (AKI) associated with cardiac surgery (CSA-AKI). We conducted a cohort study to evaluate the influence of preoperative hyperuricemia on AKI in patients at high risk for developing SC-AKI.

Design: Multicenter prospective international cohort study.

Setting: Fourteen university hospitals in Spain and the United Kingdom.

Participants: We studied 261 consecutive patients at high risk of developing CSA-AKI, according to a Cleveland score ≥4 points, from July to December 2017.

Interventions: None.

Measurements and main results: AKIN criteria were used for the definition of AKI. Multivariable logistic regression models and propensity score-matched pairwise analysis were used to determine the adjusted association between preoperative hyperuricemia (≥7 mg/dL) and AKI. Elevated preoperative AUS (≥7 mg/dL) was present in 190 patients (72.8%), whereas CSA-AKI occurred in 145 patients (55.5%). In multivariable logistic regression models, hyperuricemia was not associated with a significantly increased risk of AKI (adjusted Odds Ratio [OR]: 1.58; 95% confidence interval [CI]: 0.81-3; p = 0.17). In propensity score-matched analysis of 140 patients, the hyperuricemia group experienced similar adjusted odds of AKI (OR 1.05, 95%CI 0.93-1.19, p = 0.37).

Conclusions: Hyperuricemia was not associated with an increased risk of AKI in this cohort of patients undergoing cardiac surgery at high risk of developing CSA-AKI.

CITATION  Rev Esp Anestesiol Reanim (Engl Ed). 2024 May 2:S2341-1929(24)00094-5. doi: 10.1016/j.redare.2024.04.019