Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Circ J. 2011;75(3):692-7. doi: 10.1253/circj.cj-10-0631. Epub 2011 Jan 14.
There is very little information about the relationship between hyperuricemia, acute kidney injury (AKI) and in-hospital mortality.
With a retrospective analysis of the medical records, 1,247 patients who had percutaneous coronary intervention (PCI) were investigated. AKI was defined as an increase in serum creatinine of ≥0.5mg/dl or ≥50% over baseline within 7 days of PCI. The association of AKI with clinical, biochemical and procedural variables were examined. In addition, the association of hyperuricemia with in-hospital mortality was also examined. Of the 1,247 patients in the study population, 51 (4.1%) experienced AKI after PCI, 15 of whom required hemodialysis. In-hospital mortality occurred in 1.6% (20 of 1,247) in 19.6% (10 of 51) of AKI individuals, and 0.8% (10 of 1,186) of the non-AKI participants (odd ratios, 28.927; 95% confidence intervals, 11.411-73.328; P<0.001). In our study, the most powerful predictors of these variables were acute myocardial infarction, baseline estimated glomerular filtration rate (eGFR) <60 ml·min(-1)·1.73 m(-2), diabetics mellitus, anemia and hyperuricemia. Notably, the incidence of AKI after PCI markedly increased in diabetic or hyperuricemic patients with a baseline eGFR of <60 ml·min(-1)·1.73 m(-2).
It is clear that AKI develops due to multiple risk factors. Our results indicate that hyperuricemia is independently associated with an increased risk of in-hospital mortality and AKI in patients treated with PCI.
关于高尿酸血症、急性肾损伤（AKI）和住院死亡率之间的关系，信息非常有限。
通过对病历进行回顾性分析，研究了 1247 名接受经皮冠状动脉介入治疗（PCI）的患者。AKI 的定义为 PCI 后 7 天内血清肌酐升高≥0.5mg/dl 或基线值的≥50%。检查 AKI 与临床、生化和程序变量之间的关系。此外，还检查了高尿酸血症与住院死亡率之间的关系。在研究人群的 1247 名患者中，51 名（4.1%）在 PCI 后发生 AKI，其中 15 名需要血液透析。在 AKI 患者中，住院死亡率为 1.6%（20/1247），而非 AKI 患者为 19.6%（10/51）（比值比，28.927；95%置信区间，11.411-73.328；P<0.001）。在我们的研究中，这些变量的最强预测因素是急性心肌梗死、基线估计肾小球滤过率（eGFR）<60ml·min(-1)·1.73m(-2)、糖尿病、贫血和高尿酸血症。值得注意的是，在基线 eGFR<60ml·min(-1)·1.73m(-2)的糖尿病或高尿酸血症患者中，PCI 后 AKI 的发生率明显增加。
显然，AKI 是由多种危险因素引起的。我们的结果表明，高尿酸血症与接受 PCI 治疗的患者住院死亡率和 AKI 风险增加独立相关。
