eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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4/2018
vol. 14
 
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abstract:
Original paper

Uric acid and contrast-induced nephropathy: an updated review and meta-regression analysis

Francesco Pelliccia
,
Vincenzo Pasceri
,
Giuseppe Patti
,
Giuseppe Marazzi
,
Giuseppe De Luca
,
Gaetano Tanzilli
,
Nicola Viceconte
,
Giulio Speciale
,
Enrico Mangieri
,
Carlo Gaudio

Adv Interv Cardiol 2018; 14, 4 (54): 399–412
DOI: https://doi.org/10.5114/aic.2018.79870
Online publish date: 2018/12/11
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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.

keywords:

angiography, contrast-induced nephropathy, percutaneous coronary intervention, uric acid
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