Association between serum uric acid levels and clinical outcomes in patients with acute kidney injury

Ren Fail. 2023 Dec;45(1):2169617. doi: 10.1080/0886022X.2023.2169617.

Abstract

Background: The effects of serum uric acid (SUA) on clinical outcomes in patients with acute kidney injury (AKI) are unclear. The aim of this study was to investigate the association of SUA levels with clinical outcomes of AKI patients.

Methods: The data of AKI patients hospitalized in the Affiliated Hospital of Qingdao University were retrospectively reviewed. Multivariable logistic regression was utilized to assess the association between SUA levels and the clinical outcomes of AKI patients. Receiver operating characteristic (ROC) analysis was applied to assess the predictive ability of SUA levels for in-hospital mortality in patients with AKI.

Results: A total of 4,646 AKI patients were eligible for study inclusion. In multivariable analysis, after adjustment for various confounding factors in the fully adjusted model, a higher SUA level was found to be associated with increased in-hospital mortality of AKI patients with an odds ratio (OR) of 1.72 (95% CI, 1.21-2.33, p = 0.005) for the SUA level >5.1-6.9 mg/dl group and 2.75 (95% CI, 1.78-4.26, p < 0.001) for the SUA level >6.9 mg/dl group compared with the reference group (SUA ≤3.6 mg/dl). In the ROC analysis, the area under the curve (AUC) of SUA was 0.65 with a sensitivity of 51% and a specificity of 73%.

Conclusions: An elevated SUA level is associated with an increased risk of in-hospital mortality in patients with AKI, and it appears to be an independent prognostic marker for these patients.

Keywords: Acute kidney injury; mortality; prognostic; serum uric acid.

MeSH terms

  • Acute Kidney Injury* / blood
  • Humans
  • Odds Ratio
  • Retrospective Studies
  • Risk Factors
  • Uric Acid* / blood

Substances

  • Uric Acid

Grants and funding

This work was supported by grants from the Natural Science Foundation of Shandong Province [ZR2020QH060], the National Natural Science Foundation of China [81770679 and 81970582], Special Project of Benefiting People with Science and Technology of Qingdao [20–3-4–36-nsh] and Qingdao Key Health Discipline Development Fund. No funding bodies had any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.