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Abstract：
Sepsis-related AKI is related to short-term mortality and poor long-term prognoses, such as chronic renal insufficiency, late development of end-stage renal disease, and long-term mortality. In this study, we aimed to investigate the association of hyperuricemia with acute kidney injury (AKI) in patients with sepsis.
The retrospective cohort study included 634 adult sepsis patients hospitalized in the intensive care unit (ICU) of the First Affiliated Hospital of Guangxi Medical University from March 2014 to June 2020 and the ICU of the Second Affiliated Hospital of Guangxi Medical University from January 2017 to June 2020. Based on the first serum uric acid level within 24 h of admission to the ICU, patients were divided into groups with or without hyperuricemia, and the incidence of AKI within seven days of ICU admission was compared between the two groups. The univariate analysis analyzed the effect of hyperuricemia on sepsis-related AKI, and the multivariable logistic regression model analysis was used.
Among the 634 patients with sepsis, 163 (25.7%) developed hyperuricemia, and 324 (51.5%) developed AKI. The incidence of AKI in the groups with and without hyperuricemia was 76.7% and 42.3%, respectively, with statistically significant differences (2 = 57.469, P < 0.001). After adjusting for genders, comorbidities (coronary artery disease), organ failure assessment (SOFA) score on the day of admission, basal renal function, serum lactate, calcitonin, and mean arterial pressure, hyperuricemia was showed to be an independent risk factor for AKI in patients with sepsis (OR = 4.415, 95%CI 2.793 ~ 6.980, P < 0.001). For every 1 mg/dL increase in serum uric acid in patients with sepsis, the risk of AKI increased by 31.7% ( OR = 1.317, 95%CI 1.223 ~ 1.418, P < 0.001).
AKI is a common complication in septic patients hospitalized in the ICU, and hyperuricemia is an independent risk factor for AKI in septic patients.
The retrospective cohort study included 634 adult sepsis patients hospitalized in the intensive care unit (ICU) of the First Affiliated Hospital of Guangxi Medical University from March 2014 to June 2020 and the ICU of the Second Affiliated Hospital of Guangxi Medical University from January 2017 to June 2020. Based on the first serum uric acid level within 24 h of admission to the ICU, patients were divided into groups with or without hyperuricemia, and the incidence of AKI within seven days of ICU admission was compared between the two groups. The univariate analysis analyzed the effect of hyperuricemia on sepsis-related AKI, and the multivariable logistic regression model analysis was used.
Among the 634 patients with sepsis, 163 (25.7%) developed hyperuricemia, and 324 (51.5%) developed AKI. The incidence of AKI in the groups with and without hyperuricemia was 76.7% and 42.3%, respectively, with statistically significant differences (2 = 57.469, P < 0.001). After adjusting for genders, comorbidities (coronary artery disease), organ failure assessment (SOFA) score on the day of admission, basal renal function, serum lactate, calcitonin, and mean arterial pressure, hyperuricemia was showed to be an independent risk factor for AKI in patients with sepsis (OR = 4.415, 95%CI 2.793 ~ 6.980, P < 0.001). For every 1 mg/dL increase in serum uric acid in patients with sepsis, the risk of AKI increased by 31.7% ( OR = 1.317, 95%CI 1.223 ~ 1.418, P < 0.001).
AKI is a common complication in septic patients hospitalized in the ICU, and hyperuricemia is an independent risk factor for AKI in septic patients.
摘要：
背景：脓毒症相关AKI与短期死亡率和长期预后不良有关，比如慢性肾功能不全，晚期肾病的发展，和长期死亡率。在这项研究中,我们旨在探讨脓毒症患者高尿酸血症与急性肾损伤(AKI)的相关性.
方法：回顾性队列研究纳入2014年3月至2020年6月广西医科大学第一附属医院ICU和2017年1月至2020年6月广西医科大学第二附属医院ICU住院的634例成人脓毒症患者。根据入住ICU24小时内的首次血清尿酸水平，患者分为有或没有高尿酸血症组，比较两组患者入住ICU后7天内AKI的发生率。单因素分析高尿酸血症对脓毒症相关AKI的影响,采用多变量logistic回归模型分析。
结果：在634例脓毒症患者中，163人（25.7%）出现高尿酸血症，324例（51.5%）发生AKI。有高尿酸血症和无高尿酸血症组的AKI发生率分别为76.7%和42.3%,分别,差异具有统计学意义(2=57.469,P<0.001)。在调整性别后，合并症（冠状动脉疾病），入院当天的器官衰竭评估（SOFA）评分，基础肾功能,血清乳酸，降钙素,和平均动脉压，高尿酸血症是脓毒症患者发生AKI的独立危险因素(OR=4.415,95CI2.793~6.980,P<0.001)。脓毒症患者血清尿酸每增加1mg/dL，AKI风险增加31.7%(OR=1.317,95CI1.223~1.418,P<0.001)。
结论：AKI是ICU住院的脓毒症患者的常见并发症，高尿酸血症是脓毒症患者发生AKI的独立危险因素。
方法：回顾性队列研究纳入2014年3月至2020年6月广西医科大学第一附属医院ICU和2017年1月至2020年6月广西医科大学第二附属医院ICU住院的634例成人脓毒症患者。根据入住ICU24小时内的首次血清尿酸水平，患者分为有或没有高尿酸血症组，比较两组患者入住ICU后7天内AKI的发生率。单因素分析高尿酸血症对脓毒症相关AKI的影响,采用多变量logistic回归模型分析。
结果：在634例脓毒症患者中，163人（25.7%）出现高尿酸血症，324例（51.5%）发生AKI。有高尿酸血症和无高尿酸血症组的AKI发生率分别为76.7%和42.3%,分别,差异具有统计学意义(2=57.469,P<0.001)。在调整性别后，合并症（冠状动脉疾病），入院当天的器官衰竭评估（SOFA）评分，基础肾功能,血清乳酸，降钙素,和平均动脉压，高尿酸血症是脓毒症患者发生AKI的独立危险因素(OR=4.415,95CI2.793~6.980,P<0.001)。脓毒症患者血清尿酸每增加1mg/dL，AKI风险增加31.7%(OR=1.317,95CI1.223~1.418,P<0.001)。
结论：AKI是ICU住院的脓毒症患者的常见并发症，高尿酸血症是脓毒症患者发生AKI的独立危险因素。
