High Uric Acid Raises AKI Risk After Heart Surgery
SAN DIEGO—High serum uric acid levels are a strong independent risk factor for acute kidney injury (AKI) after heart surgery, according to a study presented at the Kidney Week 2012.
A study conducted by Bernhard M.W. Schmidt and colleagues at the Hannover Medical School in Germany, looked at 247 consecutive patients who underwent elective coronary artery bypass grafting (CABG), valve replacement, or combined bypass surgery. Postoperative AKI developed in 30 patients (12.1%).
In multivariate analysis, uric acid levels above the median were associated with a 5.5 times increased risk of AKI compared with lower levels. Cardiopulmonary bypass time greater than 90 minutes was associated with a 4.6 times increased risk compared with shorter bypass time, and a body mass index (BMI) greater than 30 kg/m2 was associated with a 3.2 times increased risk compared with lower BMI.
In another study presented at the conference, Nara Shin, MD, and collaborators at the Seoul National University Bundang Hospital in South Korea identified AKI risk factors independently associated with an increased long-term mortality risk among patients undergoing CABG. These include older age, male gender, high C-reactive protein. AKI increased the risk about twofold. The study found no significant association between albuminuria, chronic kidney disease, and long-term mortality risk.
The researchers examined electronic medical records of patients undergoing CABG from 2004 to 2010. AKI occurred in 304 of 819 patients examined.