The Predictive Value of Hyperuricemia on Renal Outcome after Contrast-Enhanced Computerized Tomography

Abstract

The aim of this study was to determine whether elevated serum level of uric acid (sUA) could predict renal outcome after contrast-enhanced computerized tomography (CCT). We used a historical cohort of 58,106 non-dialysis adult patients who received non-ionic iso-osmolar CCT from 1 June 2008 to 31 March 2015 to evaluate the association of sUA and renal outcome. The exclusion criteria were patients with pre-existing acute kidney injury (AKI), multiple exposure, non-standard volume of contrast, and missing data for analysis. A total of 1440 patients were enrolled. Post-contrast-AKI (PC-AKI), defined by the increase in serum creatinine ≥ 0.3 mg/dL within 48 h or ≥50% within seven days after CCT, occurred in 180 (12.5%) patients and the need of hemodialysis within 30 days developed in 90 (6.3%) patients, both incidences were increased in patients with higher sUA. sUA ≥ 8.0 mg/dL was associated with an increased risk of PC-AKI (odds ratio (OR) of 2.62; 95% confidence interval (CI), 1.27~5.38, p = 0.009) and the need of hemodialysis (OR, 5.40; 95% CI, 1.39~21.04, p = 0.015). Comparing with sUA < 8.0 mg/dL, patients with sUA ≥ 8.0 mg/dL had higher incidence of PC-AKI (16.7% vs. 11.1%, p = 0.012) and higher incidence of hemodialysis (12.1% vs. 4.3%, p < 0.001). We concluded that sUA ≥ 8.0 mg/dL is associated with worse renal outcome after CCT. We suggest that hyperuricemia may have potential as an independent risk factor for PC-AKI in patients receiving contrast-enhanced image study.

Association between uric acid level and contrast-induced acute kidney injury in patients with type 2 diabetes mellitus after coronary angiography: a retrospective cohort study

“…One study found that hyperuricaemia was significantly associated with the risk of CI-AKI in patients with relatively normal serum creatinine after percutaneous coronary interventions in China (OR = 5.83) [11]. Similar findings demonstrated that UA ≥ 8.0 mg/dL was associated with an increased risk of CI-AKI in patients receiving contrast-enhanced computerized tomography (CCT) [12]. In experimental models, hyperuricaemia was associated with an absence of intrarenal crystals, the manifestation of tubular injury, macrophage infiltration, and increased expression of inflammatory mediators [13].…”

A novel explainable online calculator for contrast-induced AKI in diabetics: a multi-centre validation and prospective evaluation study

“…A recent study from China proved that hyperuricemia was associated with CIAKI (OR = 2.363, 95% CI 1.653–3.377, P < 0.001) [ 40 ]. What’s more, it was also shown that patients with uric acid levels above 8.0 mg/dL not only had a greater risk of CIAKI but also an increased risk of hemodialysis [ 41 ]. Uric acid can promote oxidative stress and release a variety of proinflammatory factors, resulting in renal vasoconstriction and endothelial dysfunction [ 42 ].…”

Contrast-induced acute kidney injury: a review of definition, pathogenesis, risk factors, prevention and treatment

“…At present, some studies have found that high serum uric acid levels may be related to the occurrence of CI-AKI. A cohort study involving 1440 patients showed that serum uric acid levels ≥ 8.0 mg/dl were associated with an increased risk of CI-AKI [95].…”