Open AccessThe Effect of Urine pH and Urinary Uric Acid Levels on the Development of Contrast Nephropathy
Author(s) -
Aslan Gamze,
Afsar Baris,
Sag Alan A.,
Camkiran Volkan,
Erden Nihan,
Yilmaz Sezen,
Siriopol Dimitrie,
Incir Said,
You Zhiying,
Garcia Miguel L.,
Covic Adrian,
Cherney David Z.I.,
Johnson Richard J.,
Kanbay Mehmet
Publication year - 2019
Publication title -
kidney and blood pressure research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.806
H-Index - 51
eISSN - 1423-0143
pISSN - 1420-4096
DOI - 10.1159/000504547
Subject(s) - research article
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.