Abstract

BackgroundMounting evidence indicated that the elevated serum uric acid level was associated with an increased risk of acute kidney injury (AKI). Our goal was to systematically evaluate the correlation of serum uric acid (SUA) level and incidence of AKI by longitudinal cohort studies.MethodsWe searched electronic databases and the reference lists of relevant articles. 18 cohort studies with 75,200 patients were analyzed in this random-effect meta-analysis. Hyperuricemia was defined as SUA levels greater than 360-420 μmol/L (6–7 mg/dl), which was various according to different studies. Data including serum uric acid, serum creatinine, and incidence of AKI and hospital mortality were summarized using random-effects meta-analysis.ResultsThe hyperuricemia group significantly exerted a higher risk of AKI compared to the controls (odds ratio OR 2.24, 95% CI 1.76-2.86, p < 0.01). Furthermore, there is less difference of the pooled rate of AKI after cardiac surgery between hyperuricemia and control group (34.3% vs 29.7%, OR 1.24, 95% CI 0.96-1.60, p = 0.10), while the rates after PCI were much higher in hyperuricemia group than that in control group (16.0% vs 5.3%, OR 3.24, 95% CI 1.93-5.45, p < 0.01). In addition, there were significant differences in baseline renal function at admission between hyperuricemia and control groups in most of the included studies. The relationship between hyperuricemia and hospital mortality was not significant. The pooled pre-operative SUA levels were higher in AKI group than that in the non-AKI group.ConclusionsElevated SUA level showed an increased risk for AKI in patients and measurements of SUA may help identify risks for AKI in these patients.

Highlights

  • Mounting evidence indicated that the elevated serum uric acid level was associated with an increased risk of acute kidney injury (AKI)

  • Selection criteria An initial eligibility screen of all retrieved titles and abstracts was performed, and only studies reporting the relationship between serum uric acid (SUA) and AKI were selected for further review

  • After removal of duplicates and preliminary screening, 84 articles were selected for full-text review for their relevance to this study and 18 studies were included in this systematic review

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Summary

Introduction

Mounting evidence indicated that the elevated serum uric acid level was associated with an increased risk of acute kidney injury (AKI). It is found that hyperuricemia is associated with acute kidney injury (AKI) in various statuses [6,7,8,9]. This meta-analysis was conducted to estimate whether hyperuricemia is an independent risk factor for incidence and prognosis of AKI. This effort hoped to raise awareness of the importance of hyperuricemia in the developing AKI

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