• Journal of nephrology · Jul 2012

    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, and Richard J Johnson.
    • Division of Nephrology, Hypertension and Transplantation, University of Florida, Gainesville, FL 32610-0224, USA. ejazaa@medicine.ufl.edu
    • J. Nephrol. 2012 Jul 1;25(4):497-505.

    BackgroundWe hypothesized that post-operative serum uric acid (SUA) may be associated with acute kidney injury (AKI).MethodsIn this prospective, observational study, the relationships between SUA, urine neutrophil gelatinase-associated lipocalin (uNGAL) and interleukin-18 (uIL-18), serum monocyte chemoattractant protein-1 (sMCP-1) and tumor necrosis factor-alpha (sTNF-alpha), and incidence of AKI were determined. SUA were divided into tertiles and their association with AKI investigated.ResultsA total of 100 cardiac surgery patients were included for analyses. The 1st, 2nd, and 3rd SUA tertiles were associated with 15.1%, 11.7%, and 54.5% incidence of AKI, respectively. The 3rd SUA tertile, compared to the referent 1st tertile, was associated with an eightfold (OR 8.38, CI95% 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 1st tertile, the 3rd tertile SUA was associated with an eightfold increased risk for AKI on post-operative day 2 (adjusted OR 7.94, CI95% 1.50-42.08, P=.015) and a five-fold increased risk for AKI during hospital stay (OR 4.83, CI95% 1.21-19.20, P=.025), respectively. SUA (Area Under Curve, AUC 0.77 (CI95% 0.66-0.88, P<.001), serum creatinine (0.73, CI95% 0.62-0.84, P<.001) and sTNF-alpha (0.76, CI95% 0.65-0.87, P<.001) had the best diagnostic performance measured by the Receiver Operating Characteristics curves.ConclusionsWe conclude that post-operative SUA is associated with an increased risk for AKI and compares well to conventional markers of AKI.

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