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Uric acid and contrast-induced nephropathy: an updated review and meta-regression analysis
Francesco Pelliccia1, Vincenzo Pasceri2, Giuseppe Patti3
1Department of Cardiovascular Sciences, Sapienza University, Rome, Italy.
Insights
Serum uric acid is significantly associated with contrast-induced nephropathy (CIN). Higher uric acid levels were observed in patients who developed CIN, and it correlated with age but not other major CIN predictors.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- Previous research suggests a link between serum uric acid levels and contrast-induced nephropathy (CIN).
- Understanding this association is crucial for predicting and preventing kidney damage after contrast procedures.
Purpose of the Study:
- To conduct an updated meta-analysis and meta-regression to evaluate the association between serum uric acid and CIN.
- To determine if serum uric acid correlates with other known risk factors for CIN.
Main Methods:
- A comprehensive literature search was performed across PubMed, Embase, and Cochrane databases up to July 31, 2018.
- Included 10 clinical studies encompassing 6,705 patients to analyze the relationship between uric acid and CIN incidence.
Main Results:
- A total of 12% of patients developed CIN. Significantly higher baseline uric acid levels were found in patients with CIN (6.51 vs. 5.67 mg/dl).
- Patients with CIN were older, more frequently had diabetes and hypertension, and exhibited lower hemoglobin and ejection fraction, with higher baseline creatinine.
- Meta-regression indicated that serum uric acid levels correlated significantly only with patient age (r = 0.13, p = 0.03).
Conclusions:
- Serum uric acid is significantly associated with an increased risk of CIN.
- Uric acid levels correlate with age but not with other primary predictors of CIN.
- Further research is warranted to explore the utility of serum uric acid in CIN risk stratification.
Introduction:
Previous studies have suggested a relationship between serum uric acid and contrast-induced nephropathy (CIN).
Aim:
We performed an updated review and a meta-regression analysis to assess whether serum uric acid is associated with CIN or there exists any relationship between serum uric acid and other risk factors for CIN.
Material And Methods:
We searched PubMed, Embase and Cochrane databases and reviewed cited references up to July 31, 2018 to identify relevant studies.
Results:
A total of 6,705 patients from 10 clinical studies were included. CIN occurred in 774 of the 6,705 (12%) patients. Baseline uric acid levels were significantly higher in those who developed CIN (6.51 vs. 5.67 mg/dl; 95% CI: 0.55-1.22, p = 0.00001). Comparison of clinical features showed that patients with CIN were significantly older (69 vs. 63 years; p < 0.00001) and more often had diabetes (42% vs. 32%; p = 0.002) and hypertension (67% vs. 59%; p = 0.03). Also, patients who developed CIN had lower hemoglobin (12.5 vs. 13.6 mg/dl; p < 0.00001) and higher levels of baseline creatinine (1.27 vs. 1.01 mg/dl; p < 0.0001), but had similar levels of glycemia, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride. Also, they showed a lower ejection fraction (45% vs. 50%; p < 0.00001). Meta-regression analysis revealed that uric acid related only to age (r = 0.13, p = 0.03).
Conclusions:
Our investigation indicates that uric acid is significantly associated with CIN. Uric acid correlated significantly with age only, and not with other major predictors of CIN. Further studies are therefore needed to verify the potential of uric acid to improve CIN risk stratification.
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