The Effect of Urine pH and Urinary Uric Acid Levels on the Development of Contrast Nephropathy
Open Access
- 20 December 2019
- journal article
- research article
- Published by S. Karger AG in Kidney and Blood Pressure Research
- Vol. 45 (1), 131-141
- https://doi.org/10.1159/000504547
Abstract
Background: Hyperuricemia may cause acute kidney injury by activating inflammatory, pro-oxidative and vasoconstrictive pathways. In addition, radiocontrast causes an acute uricosuria, potentially leading to crystal formation. We therefore aimed to investigate the effect of urine acidity and urine uric acid level on the development of contrast-induced nephropathy (CIN) in patients undergoing elective coronary angiography. Methods: We enrolled 175 patients who underwent elective coronary angiography. CIN was defined as a >25% increase in the serum creatinine levels relative to basal values 48–72 h after contrast use. Prior to coronary angiography and 48–72 h later, serum uric acid, urea, creatinine, bicarbonate levels, and spot uric acid to creatinine ratio (UACR) were measured. Results: Of the 175 subjects included, 29 (16.6%) developed CIN. Those who developed CIN had a higher prevalence of diabetes, higher UACR (0.60 vs. 0.44, p = 0.014), higher contrast volume, and lower serum sodium level. With univariate analysis of a logistic regression model, the risk of CIN was found to be associated with diabetes (p = 0.0016, OR = 3.8 [95% CI: 1.7–8.7]), urine UACR (p = 0.0027, OR = 9.6 [95% CI: 2.2–42.2]), serum sodium (p = 0.0079, OR = 0.8 [95% CI: 0.77–0.96]), and contrast volume (p = 0.0385, OR = 1.8 [95% CI: 1.03–3.09]). In a multiple logistic regression model with stepwise method of selection, diabetes (p = 0.0120, OR = 3.2 [95% CI: 1.3–8.1]) and UACR (p = 0.0163, OR = 6.9 [95% CI: 1.4–33.4]) were the 2 risk factors finally identified. Conclusions: We have demonstrated that higher urine UACR is associated with the development of CIN in patients undergoing elective coronary angiography.Keywords
This publication has 41 references indexed in Scilit:
- Serum Uric Acid Independently Predicts Cardiovascular Events in Advanced NephropathyAmerican Journal of Nephrology, 2012
- A Randomized Study of Allopurinol on Endothelial Function and Estimated Glomular Filtration Rate in Asymptomatic Hyperuricemic Subjects with Normal Renal FunctionClinical Journal of the American Society of Nephrology, 2011
- Uric Acid as a Cardiometabolic Risk Factor: To Be or Not to BeContributions to nephrology, 2011
- Uric Acid and Pentraxin-3 Levels Are Independently Associated with Coronary Artery Disease Risk in Patients with Stage 2 and 3 Kidney DiseaseAmerican Journal of Nephrology, 2011
- Prognostic Significance of Hyperuricemia in Patients with Different Types of Renal Dysfunction and Acute Myocardial Infarction Treated with Percutaneous Coronary InterventionNephron Clinical Practice, 2010
- Contrast-Induced Nephropathy and Long-Term Adverse EventsClinical Journal of the American Society of Nephrology, 2009
- NGAL (neutrophil gelatinase-associated lipocalin) and cystatin C: Are they good predictors of contrast nephropathy after percutaneous coronary interventions in patients with stable angina and normal serum creatinine?International Journal of Cardiology, 2008
- Crystals cause acute necrotic cell death in renal proximal tubule cells, but not in collecting tubule cellsKidney International, 2005
- Percutaneous Coronary Interventions in the High-Risk Renal Patient: Strategies for Renal Protection and Vascular ProtectionCardiology Clinics, 2005
- A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: Development and initial validationJournal of the American College of Cardiology, 2004