Yıl: 2019 Cilt: 28 Sayı: 3 Sayfa Aralığı: 160 - 167 Metin Dili: İngilizce DOI: 10.5152/turkjnephrol.2019.3416 İndeks Tarihi: 21-07-2020

Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients

Öz:
Objective: This study aimed to evaluate the prevalence of hypoalbuminemia and hyperuricemia, and investigate uric acidalbumin ratio association with mortality and acute kidney injury (AKI) in critically ill patients.Materials and Methods: We evaluated 754 patients who were admitted to intensive care unit (ICU) between 2008 and 2014.We investigated the effects of hypoalbuminemia and uric acid / albumin ratio on mortality and AKI.Results: A total of 754 critically ill patients (52.4% male and mean age 57.1±18.7 years) were enrolled in this study. Amongthem, 72.8% (549/754) patients had hypoalbuminemia during the admission to ICU. A total of 381/754 (50.5%) patients developed AKI. The 28-day mortality rate was significantly higher in hypoalbuminemia group than in normal plasma albumingroup [35.7% (196) vs. 18.5% (38), p=0.01]. The uric acid level higher than 7 mg/dl was associated with AKI (p<0.001). Uricacid albumin ratio higher than 1.7 was significantly associated with AKI and 28-day mortality (p<0.001 and p<0.001).Conclusion: This study successfully confirmed that hypoalbuminemia in ICU admission has been independently associated with increased early death and AKI in critically ill patients; and uric acid albumin ratio could be a marker to predict AKIand mortality.
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Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Fanali G, di Masi A, Trezza V, Marino M, Fasano M, Ascenzi P. Human serum albumin: from bench to bedside. Mol Aspects Med 2012; 33: 209-90. [CrossRef]
  • 2. Leite HP, da Silva AVR, de Oliveira Iglesias SB, Nogueira PCK. Serum albumin is an independent predictor of clinical outcomes in critically ill children. Pediatr Crit Care Med 2016; 17: e50-7. [CrossRef]
  • 3. Kittisakmontri K, Reungrongrat S, Lao-araya M. Hypoalbuminaemia at admission predicts the poor outcomes in critically ill children Anasthesiol Intensive Ther 2016; 48: 158-61. [CrossRef]
  • 4. Shao M, Wang S, Parameswaran PK. Hypoalbuminemia: a risk factor for acute kidney injury development and progression to chronic kidney disease in critically ill patients. Intl Urol Nephrol 2017; 49: 295-302. [CrossRef]
  • 5. Vincent JL, Russell JA, Jacob M, Martin G, Guidet B, Wernerman J, et al. Albumin administration in the acutely ill: what is new and where next? Crit Care 2014; 18: 231. [CrossRef]
  • 6. Fleck A, Hawker F, Wallace P, Raines G, Trotter J, Ledingham IM, et al. Increased vascular permeability: a major cause of hypoalbuminaemia in disease and injury. Lancet 1985; 325: 781-4. [CrossRef]
  • 7. Aman J, van der Heijden M, van Lingen A, Girbes AR, van Nieuw Amerongen GP, van Hinsbergh VW, et al. Plasma protein levels are markers of pulmonary vascular permeability and degree of lung injury in critically ill patients with or at risk for acute lung injury/ acute respiratory distress syndrome. Crit Care Med 2011; 39: 89- 97. [CrossRef]
  • 8. Griebsch A, Zöllner N. Effect of ribomononucleotides given orally on uric acid production in man. Purine Metabolism in Man: Springer; 1974. p.443-9. [CrossRef]
  • 9. Sørensen LB. The elimination of uric acid in man: studied by means of C14-labeled uric acid; uricolysis: Christtreus bogtr; 1960.
  • 10. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum 2011; 63: 3136-41. [CrossRef]
  • 11. Tomita M, Mizuno S, Yamanaka H, Hosoda Y, Sakuma K, Matuoka Y, et al. Does hyperuricemia aeffect mortality? A prospective cohort study of japanese male workers. J Epidemiol 2000; 10: 403-9. [CrossRef]
  • 12. Kamei K, Konta T, Ichikawa K, Sato H, Suzuki N, Kabasawa A, et al. Serum uric acid levels and mortality in the Japanese population: the Yamagata (Takahata) study. Clin Exp Nephrol 2016; 20: 904-9. [CrossRef]
  • 13. Zhang X, Liu L, Liang R, Jin S. Hyperuricemia is a biomarker of early mortality in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2015; 10: 2519-23. [CrossRef]
  • 14. Hsu CY, Iribarren C, McCulloch CE, Darbinian J, Go AS. Risk factors for end-stage renal disease: 25-year follow-up. Arch Intern Med 2009; 169: 342-50. [CrossRef]
  • 15. Beberashvili I, Erlich A, Azar A, Sinuani I, Feldman L, Gorelik O, et al. Longitudinal study of serum uric acid, nutritional status, and mortality in maintenance hemodialysis patients. Clin J Am Soc Nephrol 2016; 11: 1015-23. [CrossRef]
  • 16. Sakata K, Hashimoto T, Ueshima H, Okayama A. Absence of an association between serum uric acid and mortality from cardiovascular disease: NIPPON DATA 80, 1980-1994. Eur J Epidemiol 2001; 17: 461-8. [CrossRef]
  • 17. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007; 11: R31. [CrossRef]
  • 18. Waikar SS, Liu KD, Chertow GM. Diagnosis, epidemiology and outcomes of acute kidney injury. Clin J Am Soc Nephrol 2008; 3: 844- 61. [CrossRef]
  • 19. Kaddourah A, Basu RK, Bagshaw SM, Goldstein SL. Epidemiology of acute kidney injury in critically ill children and young adults. N Engl J Med 2017; 376: 11-20. [CrossRef]
  • 20. Otomo K, Horino T, Miki T, Kataoka H, Hatakeyama Y, Matsumoto T, et al. Serum uric acid level as a risk factor for acute kidney injury in hospitalized patients: a retrospective database analysis using the integrated medical information system at Kochi Medical School hospital. Clin Exp Nephrol 2016; 20: 235-43. [CrossRef]
  • 21. Kaushik M, Choo JCJ. Serum uric acid and AKI: is it time? Clin kidney J 2016; 9: 48-50. [CrossRef]
  • 22. Ghaemi-Oskouie F, Shi Y. The role of uric acid as an endogenous danger signal in immunity and inflammation. Curr Rheumatol Rep 2011; 13: 160-6. [CrossRef]
  • 23. Xu X, Hu J, Song N, Chen R, Zhang T, Ding X. Hyperuricemia increases the risk of acute kidney injury: a systematic review and meta-analysis. BMC Nephrol 2017; 18: 27. [CrossRef]
  • 24. Okino S, Fukuzawa S, Inagaki M, Sugioka J, Ikeda A, Maekawa J, et al. Hyperuricemia as a risk factor for progressive renal insufficiency after coronary intervention in patients with chronic kidney disease. Cardiovasc Interv Ther 2010; 25: 105-11. [CrossRef]
  • 25. Yuan Y, Qiu H, Hu XY, Luo T, Gao XJ, Zhao XY, et al. Risk Factors of Contrast-induced Acute Kidney Injury in Patients Undergoing Emergency Percutaneous Coronary Intervention. Chin Med J (Engl) 2017; 130: 45-50. [CrossRef]
  • 26. Cruz DN, Ferrer-Nadal A, Piccinni P, Goldstein SL, Chawla LS, Alessandri E, et al. Utilization of small changes in serum creatinine with clinical risk factors to assess the risk of AKI in critically lll adults. Clin J Am Soc Nephrol 2014; 9: 663-72. [CrossRef]
  • 27. Bonazza S, Bresee LC, Kraft T, Ross BC, Dersch-Mills D. Frequency of and Risk Factors for Acute Kidney Injury Associated With Vancomycin Use in the Pediatric Intensive Care Unit. J Pediatr Pharmacol Ther 2016; 21: 486-93. [CrossRef]
  • 28. Parikh C, Mishra J, Thiessen-Philbrook H, Dursun B, Ma Q, Kelly C, et al. Urinary IL-18 is an early predictive biomarker of acute kidney injury after cardiac surgery. Kidney Int 2006; 70: 199-203. [CrossRef]
  • 29. Nguyen MT, Devarajan P. Biomarkers for the early detection of acute kidney injury. Pediatr Nephrol 2008; 23: 2151-7. [CrossRef]
  • 30. Shemin D, Dworkin LD. Neutrophil gelatinase-associated lipocalin (NGAL) as a Biomarker for Early Acute Kidney Injury. Crit Care Clin 2011; 27: 379-89. [CrossRef]
  • 31. de Geus HR, Bakker J, Lesaffre EM, Le Noble JL. Neutrophil gelatinase-associated lipocalin at ICU admission predicts for acute kidney injury in adult patients. Am J Respir Crit Care Med 2011; 183: 907-14. [CrossRef]
  • 32. Kashani K, Al-Khafaji A, Ardiles T, Artigas A, Bagshaw SM, Bell M, et al. Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. Criti Care 2013; 17: R25. [CrossRef]
  • 33. Prowle JR. Measurement of AKI biomarkers in the ICU: still striving for appropriate clinical indications. Intensive Care Med 2015; 41: 541-3. [CrossRef]
  • 34. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract 2012; 120: c179-84. [CrossRef]
  • 35. Andrassy KM. Comments on’KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease’. Kidney Int 2013; 84: 622-3. [CrossRef]
  • 36. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40: 373-83. [CrossRef]
  • 37. Ñamendys-Silva SA, González-Herrera MO, Texcocano-Becerra J, Herrera-Gómez A. Hypoalbuminemia in critically ill patients with cancer: incidence and mortality. Am J Hosp Palliat Care 2011; 28: 253-7. [CrossRef]
  • 38. Blunt M, Nicholson J, Park G. Serum albumin and colloid osmotic pressure in survivors and nonsurvivors of prolonged critical illness. Anaesthesia 1998; 53: 755-61. [CrossRef]
  • 39. Reinhardt GF, Myscofski JW, Wilkens DB, Dobrin PB, Mangan JE Jr, Stannard RT. Incidence and mortality of hypoalbuminemic patients in hospitalized veterans. JPEN J Parenter Enteral Nutr 1980; 4: 357-9.[CrossRef]
  • 40. Artero A, Zaragoza R, Camarena JJ, Sancho S, González R, Nogueira JM. Prognostic factors of mortality in patients with community-acquired bloodstream infection with severe sepsis and septic shock. J Crit Care 2010; 25: 276-81. [CrossRef]
  • 41. Chen CW, Chen YY, Lu CL, Chen SC, Chen YJ, Lin MS, et al. Severe hypoalbuminemia is a strong independent risk factor for acute respiratory failure in COPD: a nationwide cohort study. Int J Chron Obstruct Pulmon Dis 2015; 10: 1147-54. [CrossRef]
  • 42. Serra R, Grande R, Buffone G, Gallelli L, Caroleo S, Tropea F, et al. Albumin administration prevents the onset of pressure ulcers in intensive care unit patients. Int Wound J 2015; 12: 432-5. [CrossRef]
  • 43. Wiedermann CJ, Wiedermann W, Joannidis M. Hypoalbuminemia and acute kidney injury: a meta-analysis of observational clinical studies. Intensive Care Med 2010; 36: 1657-65. [CrossRef]
  • 44. Slater MB, Gruneir A, Rochon PA, Howard AW, Koren G, Parshuram CS. Identifying High-Risk Medications Associated with Acute Kidney Injury in Critically Ill Patients: A Pharmacoepidemiologic Evaluation. Pediatr Drugs 2017; 19: 59-67. [CrossRef]
  • 45. Rutter WC, Cox JN, Martin CA, Burgess DR, Burgess DS. Nephrotoxicity during Vancomycin Therapy in Combination with Piperacillin-Tazobactam or Cefepime. Antimicrob Agents Chemother 2017; 61: pii: e02089-16. [CrossRef]
  • 46. Pan HC, Wu PC, Wu VC, Yang YF, Huang TM, Shiao CC, et al. A nationwide survey of clinical characteristics, management, and outcomes of acute kidney injury (AKI)-patients with and without preexisting chronic kidney disease have different prognoses. Medicine 2016; 95: e4987. [CrossRef]
  • 47. Turedi S, Erdem E, Karaca Y, Tatli O, Sahin A, Turkmen S, et al. The High Risk of Contrast-induced Nephropathy in Patients with Suspected Pulmonary Embolism Despite Three Different Prophylaxis: A Randomized Controlled Trial. Acad Emerg Med 2016; 23: 1136-45. [CrossRef]
  • 48. Xu R, Tao A, Bai Y, Deng Y, Chen G. Effectiveness of N-Acetylcysteine for the Prevention of Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 2016; 5: e003968. [CrossRef]
  • 49. Magnussen B, Gradel KO, Jensen TG, Kolmos HJ, Vinholt PJ, Lassen AT. Association between hypoalbuminaemia and mortality in patients with community-acquired bacteraemia is primarily related to acute disorders. PloS One 2016; 11: e0160466. [CrossRef]
  • 50. Yu PJ, Cassiere HA, Fishbein J, Esposito RA, Hartman AR. Outcomes of Patients With Prolonged Intensive Care Unit Length of Stay After Cardiac Surgery. J Cardiothorac Vasc Anesth 2016; 30: 1550-4. [CrossRef]
  • 51. Zilahi G, Artigas A, Martin-Loeches I. What’s new in multidrug-resistant pathogens in the ICU? Ann Intensive Care 2016; 6: 96. [CrossRef]
  • 52. Kuzuya M, Izawa S, Enoki H, Okada K, Iguchi A. Is serum albumin a good marker for malnutrition in the physically impaired elderly? Clin Nutr 2007; 26: 84-90. [CrossRef]
  • 53. Boldt J. Use of albumin: an update. Br J Anaesth 2010; 104: 276-84. [CrossRef]
  • 54. Gaipov A, Solak Y, Turkmen K, Toker A, Baysal AN, Cicekler H, et al. Serum uric acid may predict development of progressive acute kidney injury after open heart surgery. Ren Fail 2015; 37: 96-102. [CrossRef]
  • 55. Liang J, Zhang P, Hu X, Zhi L. Elevated serum uric acid after injury correlates with the early acute kidney in severe burns. Burns 2015; 41: 1724-31. [CrossRef]
  • 56. Sanchez-Lozada LG, Tapia E, Santamaria J, Avila-Casado C, Soto V, Nepomuceno T, Rodriguez-Iturbe B, Johnson RJ, Herrera-Acosta J. Mild hyperuricemia induces vasoconstriction and maintains glomerular hypertension in normal and remnant kidney rats. Kidney Int 2005; 67: 237-47. [CrossRef]
  • 57. Odden MC, Amadu AR, Smit E, Lo L, Peralta CA. Uric acid levels, kidney function, and cardiovascular mortality in US adults: National Health and Nutrition Examination Survey (NHANES) 1988- 1994 and 1999-2002. Am J Kidney Dis 2014; 64: 550-7. [CrossRef]
APA YETER h, EYUPOGLU N, Pashayev T, cetik s, akçay ö, YILDIRIM T (2019). Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients. , 160 - 167. 10.5152/turkjnephrol.2019.3416
Chicago YETER hasan haci,EYUPOGLU NESRIN DAMLA,Pashayev Tural,cetik sila,akçay ömer faruk,YILDIRIM Tolga Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients. (2019): 160 - 167. 10.5152/turkjnephrol.2019.3416
MLA YETER hasan haci,EYUPOGLU NESRIN DAMLA,Pashayev Tural,cetik sila,akçay ömer faruk,YILDIRIM Tolga Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients. , 2019, ss.160 - 167. 10.5152/turkjnephrol.2019.3416
AMA YETER h,EYUPOGLU N,Pashayev T,cetik s,akçay ö,YILDIRIM T Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients. . 2019; 160 - 167. 10.5152/turkjnephrol.2019.3416
Vancouver YETER h,EYUPOGLU N,Pashayev T,cetik s,akçay ö,YILDIRIM T Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients. . 2019; 160 - 167. 10.5152/turkjnephrol.2019.3416
IEEE YETER h,EYUPOGLU N,Pashayev T,cetik s,akçay ö,YILDIRIM T "Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients." , ss.160 - 167, 2019. 10.5152/turkjnephrol.2019.3416
ISNAD YETER, hasan haci vd. "Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients". (2019), 160-167. https://doi.org/10.5152/turkjnephrol.2019.3416
APA YETER h, EYUPOGLU N, Pashayev T, cetik s, akçay ö, YILDIRIM T (2019). Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients. Turkish journal of nephrology (Online), 28(3), 160 - 167. 10.5152/turkjnephrol.2019.3416
Chicago YETER hasan haci,EYUPOGLU NESRIN DAMLA,Pashayev Tural,cetik sila,akçay ömer faruk,YILDIRIM Tolga Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients. Turkish journal of nephrology (Online) 28, no.3 (2019): 160 - 167. 10.5152/turkjnephrol.2019.3416
MLA YETER hasan haci,EYUPOGLU NESRIN DAMLA,Pashayev Tural,cetik sila,akçay ömer faruk,YILDIRIM Tolga Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients. Turkish journal of nephrology (Online), vol.28, no.3, 2019, ss.160 - 167. 10.5152/turkjnephrol.2019.3416
AMA YETER h,EYUPOGLU N,Pashayev T,cetik s,akçay ö,YILDIRIM T Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients. Turkish journal of nephrology (Online). 2019; 28(3): 160 - 167. 10.5152/turkjnephrol.2019.3416
Vancouver YETER h,EYUPOGLU N,Pashayev T,cetik s,akçay ö,YILDIRIM T Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients. Turkish journal of nephrology (Online). 2019; 28(3): 160 - 167. 10.5152/turkjnephrol.2019.3416
IEEE YETER h,EYUPOGLU N,Pashayev T,cetik s,akçay ö,YILDIRIM T "Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients." Turkish journal of nephrology (Online), 28, ss.160 - 167, 2019. 10.5152/turkjnephrol.2019.3416
ISNAD YETER, hasan haci vd. "Role of Uric Acid Albumin Ratio in Predicting Development of Acute Kidney Injury and Mortality in Intensive Care Unit Patients". Turkish journal of nephrology (Online) 28/3 (2019), 160-167. https://doi.org/10.5152/turkjnephrol.2019.3416