MO293: Evaluation of Uric Acid Concentration and Acute Renal Impairment in Patients on Admission for Hospital Treatment

Abstract

Abstract BACKGROUND AND AIMS Elevated uric acid (UA) is associated with comorbidities such as hypertension, diabetes, cardiovascular disease and chronic kidney disease. There are more studies that discuss the importance of uric acid (UA) for acute kidney failure. Anaemia is a common risk factor for the development of AKI in hospitalized patients. There is an association between elevated iron and urate production in healthy people. The aim of this study was to evaluate value of UA as a risk factor for the development of acute kidney damage on admission for hospital treatment. We also determined, risk factors related to UA value and its relationship with anaemia. METHOD The study included 86 hospitalized patients with acute renal impairment who were divided according to the stage of renal impairment at admission to hospital treatment into three groups. The assessment of acute renal impairment and the classification of disease stages were based on the diagnostic stages by the KDIGO group. All the examined patients were >18 years of age. In the first stage of the disease, it was 12.79%, in the second stage, it was 15.12% and in the third, it was 72.09% of patients. RESULTS UA values were the lowest in the first stage 551.00 ± 225.64 μmol/L and highest in the third stage 670.02 ± 86.72 μmol/L, but without statistical significance. The lowest percentage with renal function was 12.9% in patients with stage 3 acute renal impairment. There was a statistically significant difference with patients with stage 1 and stage 2 (P < .017) renal impairment. The ROC curve for the cut-off value of uric acid 903.00 μmol/L based on the Youden index method with a sensitivity of 91.70% and a predictive value of 17.00% as a marker of acute kidney damage in stage 2 disease is larger than in other stages acute kidney injury. Although there is a significant relationship with risk of UA with haemoglobin values according to the following results: OR 1.036 [95% confidence interval (95% CI) 1.003–1.071; P = .030] and haematocrit level based on predicted probability and OR 1.149 (95% CI 1.028–1.285; P = .015). CONCLUSION The study showed that high values of uric acid in patients with acute kidney damage at the beginning of hospital treatment did not show the same significance in different phases of kidney damage. We confirmed the link between anaemia and UA levles. Ineffective renal UA clearance means progression of the disease course to the next stage, and over time as a sign of progression of the renal continuum to chronic damage.