Hyperuricemia increases the risk of acute kidney injury: a systematic review and meta-analysis.

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allopurinol 3 endocrinologydiseasesdrugs
diabetes mellitus 2 endocrinologydiseases
febuxostat 2 endocrinologydiseasesdrugs
hyperuricemia 38 endocrinologydiseases
metabolic syndrome 1 endocrinologydiseases

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allopurinol 27476 reduce oxidative stress and then improve cardiovascular outcomes [[39]]. However, it was found that allopurinol couldn’t prevent the incidence of AKI after cardiac surgery in these studies [[40]]. After that, researchers
allopurinol 27632 after cardiac surgery in these studies [[40]]. After that, researchers confirmed the protective role of allopurinol in the renal ischemia/reperfusion injury in rats [[41], [42]]. In addition, in the cisplatin-induced
allopurinol 28496 a significant earlier decrease of UA after cardiac surgery in hyperuricemic patients compared with allopurinol [[46]]. Therefore, we postulated that early intervention to decrease SUA levels may lower the risk of
febuxostat 27809 addition, in the cisplatin-induced AKI models, the uric acid lowering drugs rasburicase [[43]] and febuxostat [[44]] could attenuate renal injury by their antioxidant, anti-inflammatory, and cytoprotective effects.
febuxostat 28353 uric acid before surgery might protect against renal tubular injury [[45]]. In Sezai A et al. study, febuxostat had a renoprotective effect with a significant earlier decrease of UA after cardiac surgery in hyperuricemic
Select Disease Character Offset Disease Term Instance
diabetes mellitus 2725 studies have suggested that hyperuricemia is associated with hypertension, cardiovascular diseases, diabetes mellitus and the progression of chronic kidney disease [[3]–[5]]. In addition, it is found that hyperuricemia
diabetes mellitus 23478 hypertension [[17], [22]], metabolic syndrome [[23]], atherosclerosis [[24]], myocardial infarction [[25]], diabetes mellitus [[4]], stroke [[26]] and so on. All of the above diseases are most common risk factor of AKI, which
hyperuricemia 1046 incidence of AKI and hospital mortality were summarized using random-effects meta-analysis.ResultsThe hyperuricemia group significantly exerted a higher risk of AKI compared to the controls (odds ratio OR 2.24, 95% CI
hyperuricemia 1282 p < 0.01). Furthermore, there is less difference of the pooled rate of AKI after cardiac surgery between hyperuricemia and control group (34.3% vs 29.7%, OR 1.24, 95% CI 0.96-1.60, p = 0.10), while the rates after PCI
hyperuricemia 1419 (34.3% vs 29.7%, OR 1.24, 95% CI 0.96-1.60, p = 0.10), while the rates after PCI were much higher in hyperuricemia group than that in control group (16.0% vs 5.3%, OR 3.24, 95% CI 1.93-5.45, p < 0.01). In addition,
hyperuricemia 1620 p < 0.01). In addition, there were significant differences in baseline renal function at admission between hyperuricemia and control groups in most of the included studies. The relationship between hyperuricemia and hospital
hyperuricemia 1711 between hyperuricemia and control groups in most of the included studies. The relationship between hyperuricemia and hospital mortality was not significant. The pooled pre-operative SUA levels were higher in AKI group
hyperuricemia 2653 end-product of purine degradation and is excreted via kidney. Many epidemiologic studies have suggested that hyperuricemia is associated with hypertension, cardiovascular diseases, diabetes mellitus and the progression of chronic
hyperuricemia 2832 diabetes mellitus and the progression of chronic kidney disease [[3]–[5]]. In addition, it is found that hyperuricemia is associated with acute kidney injury (AKI) in various statuses [[6]–[9]]. This meta-analysis was
hyperuricemia 2977 injury (AKI) in various statuses [[6]–[9]]. This meta-analysis was conducted to estimate whether hyperuricemia is an independent risk factor for incidence and prognosis of AKI. This effort hoped to raise awareness
hyperuricemia 3115 factor for incidence and prognosis of AKI. This effort hoped to raise awareness of the importance of hyperuricemia in the developing AKI.MethodsSearch strategy and data sourcesWe performed a computerized search to identify
hyperuricemia 3673 renal failure, acute renal injury, acute renal dysfunction, or acute renal insufficiency” and “ hyperuricemia , or uric acid”. This search was not limited to English language or publication type. We followed a
hyperuricemia 4238 reporting the incidence of AKI and pre-operative SUA Levels, (2) studies using clear definition of AKI, and hyperuricemia , (3) studies providing detailed information about the incidence of AKI, and/or hospital mortality. We
hyperuricemia 4782 country of origin, year of publication, study period, study design, inclusion criteria, definition of hyperuricemia or grouping according to SUA, conclusions and patient characteristics (age and sex). Hyperuricemia was
hyperuricemia 5418 (Table 1). The second outcomes included SUA levels in AKI and No-AKI group and hospital mortality in hyperuricemia and control group. The study selection, data extraction and reporting of results were all based on the
hyperuricemia 6136 periodCountryStudy designSample sizeMean age (y)Percentage of Male (%)Inclusion criteriaDefinition of hyperuricemia or grouping according to SUADefinition of AKIMean baseline eGFR in HUA group (ml/min/1.73 m2)ConclusionsShacham,
hyperuricemia 10194 exposure71.08 ± 24.70Hyperuricemia is associated with a risk of CI-AKI. Long-term mortality after PCI was higher in those with hyperuricemia than with normouricemia after adjusting.Joung, et al. (2014) [[54]]2011–2012KoreaRetrospective cohort1,09463.062.2Patients
hyperuricemia 13633 increase of ≥25% in sCr over baseline within 48 h of coronary angiography55.26 ± 13.7Patients with hyperuricemia are at risk of developing CIN.Abbreviations: SUA serum uric acid, sCr serum creatintine, AKI acute kidney
hyperuricemia 15375 systematic review. At the full-text review stage, 30 articles were not about AKI, 18 did not involve hyperuricemia and 15 were review. Seven studies were excluded from the primary meta-analysis as they did not report
hyperuricemia 17828 observational studies with 70,264 patients reported the incidence of AKI. The pooled rates of AKI incidence in hyperuricemia group and control group were 24.2% (95% CI, 16.1-34.7%) and 11.9% (95% CI, 7.2-19.0%) respectively (OR
hyperuricemia 18376 (Fig. 4).Fig. 2Hyperuricemia and acute kidney injury. a The pooled rates of AKI incidence in control and hyperuricemia (HUA) group; (b) Subgroup analysis in all hospitalized patients and patients with cardiac surgery and
hyperuricemia 18657 (d) The pooled levels of SUA in No-AKI and AKI group. *p < 0.05, **p < 0.01Fig. 3Effects of hyperuricemia on incidence of acute kidney injuryFig. 4Pooled odds ratios of serum uric acid to predict acute kidney
hyperuricemia 18797 kidney injuryFig. 4Pooled odds ratios of serum uric acid to predict acute kidney injuryFig. 5Effects of hyperuricemia on incidence of acute kidney injury in all and subgroup analysisFig. 6Effects of hyperuricemia on incidence
hyperuricemia 18892 5Effects of hyperuricemia on incidence of acute kidney injury in all and subgroup analysisFig. 6Effects of hyperuricemia on incidence of acute kidney injury in prospective and retrospective studiesSubgroup analysisAlthough
hyperuricemia 19067 retrospective studiesSubgroup analysisAlthough the pooled rates of AKI incidence after cardiac surgery in hyperuricemia and control group were 34.3% (95% CI 4.4-85.5%) and 29.7% (95% CI 4.6-78.7%) respectively (OR 1.24,
hyperuricemia 19526 conducted subgroup analysis of prospective and retrospective cohort studies (Fig. 6). The pooled ORs of hyperuricemia on AKI were 2.87 (95% CI 1.43-5.76) and 2.11 (95% CI 1.63-2.75) respectively. In addition, to reduce
hyperuricemia 19872 creatintine or estimated glomerular filtration rate (eGFR) without significant different at admission between hyperuricemia and control groups. There were significant differences in renal function at admission between hyperuricemia
hyperuricemia 19980 hyperuricemia and control groups. There were significant differences in renal function at admission between hyperuricemia and control groups in most of the included studies, while only two studies with equal renal function
hyperuricemia 20197 were included, and the pooled OR was 3.21 (95% CI 1.22-8.44, p = 0.02) (Fig. 7).Fig. 7Effects of hyperuricemia on incidence of acute kidney injury in patients with or without equal renal function at admissionEffects
hyperuricemia 20451 studies with 3735 patients provided the hospital mortality. The pooled rates of hospital mortality in hyperuricemia group and control group were 8.9% (95% CI, 2.1-30.8%) and 5.0% (95% CI, 1.0-21.9%) respectively (OR
hyperuricemia 20647 respectively (OR 1.68, 95% CI 0.91-3.1, p = 0.083) (Figs. 2c and 8). The relationship between hyperuricemia and hospital mortality was not significant.Fig. 8Effects of hyperuricemia on hospital mortalitySUA levels
hyperuricemia 20721 The relationship between hyperuricemia and hospital mortality was not significant.Fig. 8Effects of hyperuricemia on hospital mortalitySUA levels in AKI and Non-AKI groupsFive studies assessed the SUA levels in AKI
hyperuricemia 21263 publication bias. Egger’s test for a regression intercept gave a p-value of 0.696 for effects of hyperuricemia on incidence of AKI, indicating no publication bias.DiscussionAKI is one of the most serious complications
hyperuricemia 21724 all hospitalized patients.In this meta-analysis, we found that the pooled rates of AKI incidence in hyperuricemia group were much higher than that in the control group. The underlying reasons were analyzed as follows.
hyperuricemia 23881 risk factor of cardiovascular disease. The incidence rate of cardiovascular disease in patients with hyperuricemia is higher than that in the normal population [[27]]. A meta-analysis showed that incidence of coronary
hyperuricemia 24161 times (95% CI 1.19-1.49) than that in the normouricemic patients [[5]]. Patients with CHD combined with hyperuricemia have higher incidence of myocardial infarction. The global number of cardiac surgeries or PCI each year
hyperuricemia 25297 incidence after cardiac surgery than PCI, which led to less difference of the pooled rate of AKI between hyperuricemia and control group. Moreover, there need more studies to confirm the prognostic role of SUA in AKI incidence
hyperuricemia 26955 may be involved in the progress of AKI and contribute to higher incidence of AKI in the patients with hyperuricemia . Regardless of whether elevated SUA is solely a predictive factor of AKI or an independent risk factor
hyperuricemia 28001 cytoprotective effects. A prospective, randomized pilot trial with 26 cardiac surgery patients with hyperuricemia showed that there was no significant difference of postoperative serum creatinine between subjects receiving
hyperuricemia 29449 is also a candidate predictor of chronic kidney disease [[47]]. We are only focused on the role of hyperuricemia in AKI without referring hypouricemia which will need more studies in the future.ConclusionThis meta-analysis
metabolic syndrome 23397 associated with damage of impartment organs and result to many diseases such as hypertension [[17], [22]], metabolic syndrome [[23]], atherosclerosis [[24]], myocardial infarction [[25]], diabetes mellitus [[4]], stroke [[26]]

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