Serum Uric Acid and Risk for Acute Kidney Injury Following Contrast
| Autor: | Ionut Nistor, Ahsan A. Ejaz, Baris Afsar, Ozlem Hilal Çağlayan, Adrian Covic, Gamze Aslan, Yalcin Solak, Mehmet Kanbay, Miguel A. Lanaspa, Richard J. Johnson, Mihaela-Dora Donciu, Asli Aykanat |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
030232 urology & nephrology Renal function Allopurinol 030204 cardiovascular system & hematology urologic and male genital diseases Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine Hyperuricemia Prospective cohort study Creatinine business.industry Acute kidney injury Odds ratio medicine.disease female genital diseases and pregnancy complications Surgery chemistry Uric acid Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Angiology. 68:132-144 |
| ISSN: | 1940-1574 0003-3197 |
| DOI: | 10.1177/0003319716644395 |
| Popis: | Contrast-induced acute kidney injury (CI-AKI) is a common cause of hospital-acquired acute kidney injury (AKI). We evaluated the evidence that uric acid (UA) plays a pathogenic role in CI-AKI. Ten studies were eligible for inclusion for meta-analysis. Hyperuricemia predicted risk for cases with AKI in prospective cohort studies. Higher levels of serum UA (SUA), as defined by the authors, were associated with a 2-fold increased risk to develop AKI (pooled odds ratio 2.03; 95% confidence interval [CI] 1.48-2.78). Significant heterogeneity was found in cohort studies ( P = .001, I2 = 85.7%). In 2 clinical trials, lowering of SUA with saline hydration was significantly associated with reduced risk for AKI compared with saline hydration alone or saline hydration with N-acetyl cysteine. An analysis of 2 randomized controlled trials found that allopurinol with saline hydration had a significant protective effect on renal function (assessed by serum creatinine values) compared with hydration alone (mean difference: −0.52 mg/dL; 95% CI: −0.81 to −0.22). Hyperuricemia independently predicts CI-AKI. Two clinical trials suggest lowering SUA may prevent CI-AKI. The mechanism by which UA induces CI-AKI is likely related to acute uricosuria. |
| Databáze: | OpenAIRE |
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