Uric Acid is a Useful Tool to Predict Contrast-Induced Nephropathy

Area of Science:

• Cardiology
• Nephrology
• Biochemistry

Background:

• Contrast-induced nephropathy (CIN) is a significant complication following primary percutaneous coronary intervention (pPCI).
• CIN negatively impacts patient survival and morbidity after pPCI in ST-segment elevation myocardial infarction (STEMI) patients.

Purpose of the Study:

• To evaluate the predictive value of serum uric acid (SUA) for CIN development.
• To identify elevated SUA as a potential risk factor for CIN in STEMI patients undergoing pPCI.

Main Methods:

• Patients undergoing pPCI for STEMI were categorized into two groups based on admission median SUA levels (<5.4 mg/dL and ≥5.4 mg/dL).
• CIN was defined as a ≥25% or ≥0.5 mg/dL increase in creatinine within 72 hours post-pPCI.
• Multiple logistic regression analysis was used to identify independent predictors of CIN.

Main Results:

• The group with higher admission SUA levels (≥5.4 mg/dL) exhibited a significantly greater incidence of CIN (20% vs 12%, P < .001).
• Serum uric acid levels >5.45 mg/dL predicted CIN development with 70% sensitivity and 67% specificity.
• Independent predictors of CIN included SUA level, diabetes mellitus, low ejection fraction, contrast volume, estimated glomerular filtration rate, and C-reactive protein.

Conclusions:

• Elevated serum uric acid is an independent risk factor for developing CIN after pPCI in STEMI patients.
• Serum uric acid measurement may aid in identifying patients at higher risk for CIN.