Independent association of preoperative hyperuricemia with acute kidney injury after cardiac surgery with cardiopulmonary bypass
10.3760/cma.j.issn.1001-7097.2019.02.003
- VernacularTitle:术前高尿酸血症是体外循环心脏手术后急性肾损伤的独立危险因素
- Author:
Qian LIN
1
;
Kaiqing XIE
;
Hongwei ZHOU
;
Shufang LIANG
;
Liaohuan QIN
;
Yinglong SHI
Author Information
1. 广西医科大学第二附属医院血液净化部
- Keywords:
Hyperuricemia;
Renal insufficiency;
acute;
Risk factors;
Acute kidney injury;
Cardiac Surgical Procedures
- From:
Chinese Journal of Nephrology
2019;35(2):94-99
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of preoperative hyperuricemia on acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass (CPB).Methods A total of 567 adult patients undergoing cardiac surgery with CPB were enrolled to conduct a retrospective cohort database analysis.The patients were divided into hyperuricemia group and non-hyperuricemia group according to preoperative serum uric acid,and the incidence of AKI in two groups were compared.Binary logistic regression analysis was used to evaluate the relationship between preoperative hyperuricemia and AKI.Results Among 567 patients after cardiac surgery with CPB,hyperuricemia occurred in 303 cases (53.4％),and AKI occurred in 217 cases (38.3％).There was significantdifference in the incidence of AKI between hyperuricemia group and non-hyperuricemia group (44.6％ vs 31.1％,x2=10.874,P=0.001).The duration of intensive care unit (ICU) stay and the length of stay were longer in hyperuricemia group than those in non-hyperuricemia group (both P ＜ 0.05).After adjusting for age,gender,comorbidities (hypertension,diabetes mellitus,cerebrovascular disease),preoperative renal function,preoperative heart function,CPB time,intraoperative aortic block time,type of cardiac surgery and postoperative hypotension,binary logistic regression analysis showed that preoperative hyperuricemia was an independent risk factor of AKI after cardiac surgery with CPB (OR=1.912,95％ CI 1.270-2.879,P=0.002).Conclusion AKI is a common complication following cardiac surgery with CPB,and hyperuricemia is independently associated with CPB-associated AKI.Hyperuricemia may be involved in the pathogenesis of AKI,and intervention before cardiac surgery may be beneficial to prevent postoperative AKI.
