Hyperuricemia and urinary uric acid levels may be useful biomarkers in the early prediction of contrast-associated acute kidney injury (AKI) after percutaneous coronary intervention (PCI), investigators reported at the European Renal Association’s 2023 Congress in Milan, Italy.
Contrast-associated AKI after PCI “is still the Achilles Heel of interventional cardiology,” Vilma Cadri, MD, of University Hospital Center Mother Theresa in Tirana, Albania, and colleagues noted in a study abstract.
Among 100 patients who underwent emergency coronary angiography, contrast-associated AKI occurred in 40% overall and in 60% of men. Mean age was 64.7 years. The odds of contrast-associated AKI were significantly increased 32.7-fold with chronic kidney disease and 4.6-fold with diabetes. The odds were increased 7.8-fold with hypertension, but this was of borderline significance.
Hyperuricemia and high body mass index were significantly associated with 1.7- and 1.3-fold increased odds of contrast-associated AKI, the investigators reported. An elevated post-contrast urinary uric acid to creatinine ratio was significantly associated with 22.7-fold increased odds.
Hyperuricemia levels of 7.75 mg/dL or higher independently predicted contrast-associated AKI, with an area under the receiver operating characteristic curve of 90.5%, according to the investigators. These levels had a sensitivity and specificity of 92.5% and 81.7%, respectively, for predicting contrast-associated AKI.
These results appear to support recent studies and a meta-analysis.
Cadri V, Toska L, Strakosha A, et al. Hyperuricemia and high urinary uric acid levels are the new early predictors of contrast-associated acute kidney injury. Presented at: ERA 2023 Congress; June 15-18; Milan, Italy. Poster 5674.