Department of Pharmacy, Mayo Clinic, Rochester, MN, USA.
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
Leuk Lymphoma. 2021 Dec;62(13):3152-3159. doi: 10.1080/10428194.2021.1941931. Epub 2021 Jun 25.
Uric acid drives acute kidney injury in tumor lysis syndrome (TLS). This study investigated the relationship between uric acid and changes in estimated glomerular filtration rate (eGFR) in adults at risk for TLS. Linear regression was used to evaluate the relationship between uric acid area under the curve (AUC) and percent change in eGFR from baseline at hospital dismissal, 1 and 3 months. In 210 included participants, each 100 mghour/dL increase in 24 h AUC was associated with an average decline in eGFR at hospital dismissal of 9% (95%CI 3, 15) in univariate analysis. Each 100 mghour/dL increase in 24 h AUC was independently associated with an average decline in eGFR of 8% (95%CI 2, 13) at 1 month after dismissal. Additional research is needed to confirm these findings and determine whether treatments that reduce overall uric acid exposure improve kidney outcomes. Preserving kidney health could favorably impact cancer treatment eligibility, tolerability, and outcomes.
尿酸是肿瘤溶解综合征（TLS）导致急性肾损伤的原因。本研究调查了尿酸与成人 TLS 风险患者肾小球滤过率（eGFR）变化之间的关系。线性回归用于评估尿酸 AUC 与基线至出院、1 个月和 3 个月时 eGFR 百分比变化之间的关系。在 210 名纳入的参与者中，24 小时 AUC 每增加 100mghour/dL，在单变量分析中，eGFR 平均下降 9%（95%CI 3，15）。在出院后 1 个月时，24 小时 AUC 每增加 100mghour/dL，eGFR 平均下降 8%（95%CI 2，13），与 AUC 呈独立相关。需要进一步研究来证实这些发现，并确定降低尿酸总体暴露的治疗是否能改善肾脏结局。保护肾脏健康可以有利地影响癌症治疗的资格、耐受性和结局。
