Predictive Value of Hyperuricemia in Cardiac Patients with Post-Contrast Acute Kidney Injury (PC-AKI) and Different Basic Renal Functions: A Meta-Analysis

Abstract

Background: Uric acid level has shown a certain relationship with the incidence of post-contrast acute kidney injury (PC-AKI), whereas it remains controversial whether hyperuricemia can function as a predictor of PC-AKI in patients with different basic creatinine serum level. The present meta-analysis aimed to investigate whether hyperuricemia is an independent risk factor for PC-AKI and to explore the relationship between hyperuricemia and basic renal function.
 Methods: Relevant studies were retrieved via searching in PubMed, Embase, Cochrane Library, and WAN FANG electronic databases from inception to Jan 2022. Only studies published in English and Chinese languages were selected.
 Results: Overall, 11892 patients from 15 studies were included. The results of the pooled analysis revealed that the incidence of PC-AKI was significantly higher in the hyperuricemia group than that in the normouricemic group (20.62% vs. 13.05%). Hyperuricemia was associated with an increased risk of the incidence of PC-AKI (odds ratio (OR): 2.48 [95% confidence interval (CI): 1.77-3.46%]). The pooled ORs for mortality and incidence of undergoing renal replacement therapy were 2.33 (95% CI:1.81-3.00) and 8.69 (95% CI:3.22-23.44%), respectively. Comparatively, the pre-existing renal dysfunction subgroup had a lower relative risk in the hyperuricemia population.
 Conclusion: Hyperuricemia was found to be significantly associated with the incidence of PC-AKI. The effect of serum uric acid level on the incidence of PC-AKI was higher in patients with normal renal function, which could lay a foundation for the establishment of individualized schemes to prevent PC-AKI by urate-lowering therapy.

The association between hyperuricemia and the risk of acute kidney injury; a systematic review and meta-analysis

“…The pooled analysis indicated that PC-AKI occurrence was significantly higher in the hyperuricemic group than in the normouricemic group (20.62% versus 13.05%). Hyperuricemia was accompanied by an increase in the incidence risk of PC-AKI (OR: 2.48; 95% CI: 1.77-3.46%) (37). In a meta-analysis in 2017, Kanbay et al assessed the pathogenic role of uric acid in CI-AKI and found that higher levels of SUA, as described by the authors, were associated with a 2-fold increase in the risk of AKI occurrence (pooled OR: 2.03; 95% CI: 1.48-2.78) (38).…”