The prognostic value of admission serum uric acid for acute kidney injury: a two-center retrospective analysis

BackgroundAcute kidney injury (AKI) is a serious clinical syndrome, with elevated serum uric acid (SUA) recognized as a potential modifiable risk factor. Nonetheless, the association between reduced SUA and the risk of AKI, along with the modification by kidney function on this association, is not w...

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Main Authors: Shuo Huang, Linger Tang, Lingyi Xu, Jinwei Wang, Xizi Zheng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Molecular Biosciences
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Online Access:https://www.frontiersin.org/articles/10.3389/fmolb.2025.1635227/full
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author Shuo Huang
Shuo Huang
Shuo Huang
Shuo Huang
Shuo Huang
Linger Tang
Linger Tang
Linger Tang
Linger Tang
Linger Tang
Lingyi Xu
Lingyi Xu
Lingyi Xu
Lingyi Xu
Lingyi Xu
Jinwei Wang
Jinwei Wang
Jinwei Wang
Jinwei Wang
Jinwei Wang
Xizi Zheng
Xizi Zheng
Xizi Zheng
Xizi Zheng
Xizi Zheng
author_facet Shuo Huang
Shuo Huang
Shuo Huang
Shuo Huang
Shuo Huang
Linger Tang
Linger Tang
Linger Tang
Linger Tang
Linger Tang
Lingyi Xu
Lingyi Xu
Lingyi Xu
Lingyi Xu
Lingyi Xu
Jinwei Wang
Jinwei Wang
Jinwei Wang
Jinwei Wang
Jinwei Wang
Xizi Zheng
Xizi Zheng
Xizi Zheng
Xizi Zheng
Xizi Zheng
author_sort Shuo Huang
collection DOAJ
description BackgroundAcute kidney injury (AKI) is a serious clinical syndrome, with elevated serum uric acid (SUA) recognized as a potential modifiable risk factor. Nonetheless, the association between reduced SUA and the risk of AKI, along with the modification by kidney function on this association, is not well understood.MethodsAll adult patients from Peking University First Hospital (PKUFH) were screened. The primary outcome was AKI during hospitalization. Restricted cubic spline (RCS) was utilized to examine the hypothesized non-linearity between AKI and SUA as a continuous variable. SUA was categorized into six groups and Poisson regression was applied to evaluate the association between SUA groups and AKI with 240–360 μmol/L as reference. Subgroup analysis was conducted in terms of estimated glomerular filtration rate (eGFR).ResultsAmong 62,775 patients enrolled from PKUFH, 1,866 patients developed AKI (3.0%). The RCS plot showed a U-shaped association between SUA and AKI. Compared with reference group, SUA ≤ 180 μmol/L and >480 μmol/L exhibited a 2.17-fold and a 4.86-fold increased risk of AKI in the unadjusted model. After full adjustment, the associated risk of AKI in SUA ≤ 180 μmol/L (RR 1.92, 95% CI 1.57–2.36) and SUA > 480 μmol/L (RR 1.17, 95% CI 1.03–1.34) was weakened but still demonstrated statistical significance. When stratified by eGFR, the U-shaped risk curve was much less steep in the subgroup with eGFR ≤ 45 mL/min/1.73 m2.ConclusionThis study reveals a U-shaped association between admission SUA and AKI risk. Kidney function is an important confounder for this association.
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spelling doaj-art-960c0728f7324ecd8faba0a545ac48412025-08-20T02:07:46ZengFrontiers Media S.A.Frontiers in Molecular Biosciences2296-889X2025-06-011210.3389/fmolb.2025.16352271635227The prognostic value of admission serum uric acid for acute kidney injury: a two-center retrospective analysisShuo Huang0Shuo Huang1Shuo Huang2Shuo Huang3Shuo Huang4Linger Tang5Linger Tang6Linger Tang7Linger Tang8Linger Tang9Lingyi Xu10Lingyi Xu11Lingyi Xu12Lingyi Xu13Lingyi Xu14Jinwei Wang15Jinwei Wang16Jinwei Wang17Jinwei Wang18Jinwei Wang19Xizi Zheng20Xizi Zheng21Xizi Zheng22Xizi Zheng23Xizi Zheng24Renal Division, Peking University First Hospital, Beijing, ChinaInstitute of Nephrology, Peking University, Beijing, ChinaKey Laboratory of Renal Disease, Ministry of Health of China, Beijing, ChinaKey Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, ChinaResearch Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, ChinaRenal Division, Peking University First Hospital, Beijing, ChinaInstitute of Nephrology, Peking University, Beijing, ChinaKey Laboratory of Renal Disease, Ministry of Health of China, Beijing, ChinaKey Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, ChinaResearch Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, ChinaRenal Division, Peking University First Hospital, Beijing, ChinaInstitute of Nephrology, Peking University, Beijing, ChinaKey Laboratory of Renal Disease, Ministry of Health of China, Beijing, ChinaKey Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, ChinaResearch Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, ChinaRenal Division, Peking University First Hospital, Beijing, ChinaInstitute of Nephrology, Peking University, Beijing, ChinaKey Laboratory of Renal Disease, Ministry of Health of China, Beijing, ChinaKey Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, ChinaResearch Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, ChinaRenal Division, Peking University First Hospital, Beijing, ChinaInstitute of Nephrology, Peking University, Beijing, ChinaKey Laboratory of Renal Disease, Ministry of Health of China, Beijing, ChinaKey Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, ChinaResearch Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, ChinaBackgroundAcute kidney injury (AKI) is a serious clinical syndrome, with elevated serum uric acid (SUA) recognized as a potential modifiable risk factor. Nonetheless, the association between reduced SUA and the risk of AKI, along with the modification by kidney function on this association, is not well understood.MethodsAll adult patients from Peking University First Hospital (PKUFH) were screened. The primary outcome was AKI during hospitalization. Restricted cubic spline (RCS) was utilized to examine the hypothesized non-linearity between AKI and SUA as a continuous variable. SUA was categorized into six groups and Poisson regression was applied to evaluate the association between SUA groups and AKI with 240–360 μmol/L as reference. Subgroup analysis was conducted in terms of estimated glomerular filtration rate (eGFR).ResultsAmong 62,775 patients enrolled from PKUFH, 1,866 patients developed AKI (3.0%). The RCS plot showed a U-shaped association between SUA and AKI. Compared with reference group, SUA ≤ 180 μmol/L and >480 μmol/L exhibited a 2.17-fold and a 4.86-fold increased risk of AKI in the unadjusted model. After full adjustment, the associated risk of AKI in SUA ≤ 180 μmol/L (RR 1.92, 95% CI 1.57–2.36) and SUA > 480 μmol/L (RR 1.17, 95% CI 1.03–1.34) was weakened but still demonstrated statistical significance. When stratified by eGFR, the U-shaped risk curve was much less steep in the subgroup with eGFR ≤ 45 mL/min/1.73 m2.ConclusionThis study reveals a U-shaped association between admission SUA and AKI risk. Kidney function is an important confounder for this association.https://www.frontiersin.org/articles/10.3389/fmolb.2025.1635227/fullacute kidney injuryserum uric acidhyperuricemiahypouricemiaestimated glomerular filtration rate
spellingShingle Shuo Huang
Shuo Huang
Shuo Huang
Shuo Huang
Shuo Huang
Linger Tang
Linger Tang
Linger Tang
Linger Tang
Linger Tang
Lingyi Xu
Lingyi Xu
Lingyi Xu
Lingyi Xu
Lingyi Xu
Jinwei Wang
Jinwei Wang
Jinwei Wang
Jinwei Wang
Jinwei Wang
Xizi Zheng
Xizi Zheng
Xizi Zheng
Xizi Zheng
Xizi Zheng
The prognostic value of admission serum uric acid for acute kidney injury: a two-center retrospective analysis
Frontiers in Molecular Biosciences
acute kidney injury
serum uric acid
hyperuricemia
hypouricemia
estimated glomerular filtration rate
title The prognostic value of admission serum uric acid for acute kidney injury: a two-center retrospective analysis
title_full The prognostic value of admission serum uric acid for acute kidney injury: a two-center retrospective analysis
title_fullStr The prognostic value of admission serum uric acid for acute kidney injury: a two-center retrospective analysis
title_full_unstemmed The prognostic value of admission serum uric acid for acute kidney injury: a two-center retrospective analysis
title_short The prognostic value of admission serum uric acid for acute kidney injury: a two-center retrospective analysis
title_sort prognostic value of admission serum uric acid for acute kidney injury a two center retrospective analysis
topic acute kidney injury
serum uric acid
hyperuricemia
hypouricemia
estimated glomerular filtration rate
url https://www.frontiersin.org/articles/10.3389/fmolb.2025.1635227/full
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