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

Fecha de publicación: 02/05/2024

Autores de IIS La Fe

• Paula Carmona García

  Autor

• María Azucena Pajares Moncho

  Autor

• Rosario Vicente Guillen

  Autor

• Lorena Gomez Perpiña

  Autor

• Laura Morales Navarro

  Autor

Participantes ajenos a IIS La Fe

• Nagore, D
• Candela, A
• Burge, M
• Tamayo, E
• Murie-Fernandez, M
• Vives, M
• Monedero, P
• Alvarez, J
• Mendez, E
• Pasqualetto, A
• Mon, T
• Pita, R
• Varela, M A
• Esteva, C
• Pereira, M A
• Sanchez, J
• Rodriguez, M A
• Garcia, A
• Lopez, M
• Aparicio, R
• Gragera, I
• Calderon, E
• Marcos, J M
• Rodriguez, J M
• Matilla, A
• Medina, A
• Hernandez, A
• Santana, L
• Garcia, E
• Montesinos, S
• Munoz, P
• Bravo, B
• Alvarez, Julian
• Blanco, V
• en nombre del Grupo Espanol de Investigacion en Cirugia Cardiaca
• Perioperatoria

Grupos

• Anestesia y Cuidados Críticos

  Investigador Principal

  María Azucena Pajares Moncho

• Medicina Perioperatoria, Anestesiología y Reanimación

  

  Leader

  Óscar Díaz Cambronero

Abstract

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 (=7mg/dL) and AKI. Elevated preoperative AUS (=7mg/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.