Jiang Fei, Peng Yanchun, Hong Yuezhen, Cai Meiling, Li Sailan, Xie Yuling, Chen Liangwan, Lin Yanjuan
Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China.
Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China.
Int J Gen Med. 2024 Dec 11;17:6065-6074. doi: 10.2147/IJGM.S482440. eCollection 2024.
This study aims to investigate the association between preoperative serum uric acid to high-density lipoprotein cholesterol ratio (UHR) and the occurrence of postoperative acute kidney injury (AKI) in patients who underwent coronary artery bypass grafting (CABG).
A prospective observational study was conducted at Fujian Heart Medical Center between May 2022 and December 2023, recruiting patients scheduled for CABG. Participants were categorized into two groups based on AKI occurrence post-surgery. Univariate and multivariate logistic regression analyses were performed to identify predictor variables for AKI after CABG. A nomogram was constructed based on these predictors, and its calibration was evaluated using the receiver operating characteristic curve (ROC) and Hosmer-Lemeshow goodness of fit test. The diagnostic value of UHR in AKI after CABG was explored using the area under the curve (AUC).
The study included 301 CABG patients, of whom 72 (23.92%) developed AKI. After adjusting for age, gender, body mass index, and extracorporeal circulation, binary logistic regression analysis revealed that a higher UHR value was an independent risk factor for developing AKI after CABG (OR=7.410, 95% CI: 3.829-14.855), <0.05. The prediction nomogram demonstrated excellent discriminability, with an AUC of 0.87 and good calibration (Hosmer-Lemeshow test, <0.05). Compared with other clinical indicators, ROC analysis indicated that UHR had the largest AUC (0.821), corresponding to 70.8% sensitivity and 79.0% specificity.
Higher UHR was associated with an increased risk of AKI after CABG and may serve as a prospective biomarker for predicting AKI.
本研究旨在探讨冠状动脉旁路移植术（CABG）患者术前血清尿酸与高密度脂蛋白胆固醇比值（UHR）与术后急性肾损伤（AKI）发生之间的关联。
2022年5月至2023年12月在福建心脏医学中心进行了一项前瞻性观察研究，纳入计划接受CABG的患者。根据术后是否发生AKI将参与者分为两组。进行单因素和多因素逻辑回归分析以确定CABG术后AKI的预测变量。基于这些预测因素构建列线图，并使用受试者工作特征曲线（ROC）和Hosmer-Lemeshow拟合优度检验评估其校准情况。使用曲线下面积（AUC）探讨UHR对CABG术后AKI的诊断价值。
该研究纳入了301例CABG患者，其中72例（23.92%）发生了AKI。在调整年龄、性别、体重指数和体外循环后，二元逻辑回归分析显示较高的UHR值是CABG术后发生AKI的独立危险因素（OR=7.410，95%CI：3.829-14.855），P<0.05。预测列线图显示出良好的辨别能力，AUC为0.87，校准良好（Hosmer-Lemeshow检验，P<0.05）。与其他临床指标相比，ROC分析表明UHR的AUC最大（0.821），对应灵敏度为70.8%，特异度为79.0%。
较高的UHR与CABG术后AKI风险增加相关，可能作为预测AKI的前瞻性生物标志物。
