Clinical Interventions in Aging (Dec 2023)

Age-Related Effect of Uric Acid on Contrast-Induced Acute Kidney Injury of Patients Undergoing Coronary Angiography

  • Lu J,
  • He Y,
  • Yang Y,
  • Zhong X,
  • Chen S,
  • Wu B,
  • Pan Y,
  • Wang Y,
  • Xiu J,
  • Kang Y,
  • Liu J,
  • Liu Y,
  • Chen S,
  • Chen K,
  • Chen L

Journal volume & issue
Vol. Volume 18
pp. 2053 – 2061

Abstract

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Jin Lu,1,* Yibo He,2,3,* Yanfang Yang,1,* Xuejing Zhong,1 Shaowen Chen,1 Bo Wu,1 Yuxiong Pan,1 Yizhang Wang,1 Jiaming Xiu,1 Yu Kang,3,4 Jin Liu,2,3 Yong Liu,2,3 Shiqun Chen,5 Kaihong Chen,1 Liling Chen1 1Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, People’s Republic of China; 2Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People’s Republic of China; 3Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, People’s Republic of China; 4Department of Cardiology, Shantou University Medical College, Shantou, 515041, People’s Republic of China; 5Global Health Research Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Science, Southern Medical University, Guangzhou, 510100, People’s Republic of China*These authors contributed equally to this workCorrespondence: Liling Chen; Shiqun Chen, Tel +86 5973082105 ; +86 02083827812-10528, Fax +86 5972100500 ; +86 2083851483, Email [email protected]; [email protected]: The association between uric acid (UA) and contrast-induced acute kidney injury (CI-AKI) following coronary angiography (CAG) has been established. However, whether the association would vary with age remained undetermined.Methods: We performed the retrospective analysis based on the Cardio-renal Improvement II study, (ClinicalTrials.gov NCT05050877), which enrolled consecutive patients undergoing coronary angiography in 5 teaching hospitals in China from 2007 to 2020. The primary outcome was CI-AKI defined as the rise of serum creatinine (SCr) ≥ 0.5 mg/dL or 25% compared with the baseline value within 48 hours following CAG. The effect of age on the association between uric acid and CI-AKI was assessed by the logistic regression model.Results: A total of 36,550 patients (mean age 63.08± 5.6-year-old, 41.7% men) were included in the study. After adjusting for the confounders, the risk of CI-AKI between each quartile of uric acid was insignificant in the young group. In patients of the middle group, lower UA was associated with a lower risk of CI-AKI while higher UA was associated with a higher risk (Q1 OR: 0.853, 95% CI: 0.734– 0.993; Q4 OR: 1.797, 95% CI: 1.547– 2.09). In patients of the elder group, lower and higher UA were both associated with a higher risk of CI-AKI (Q1 OR: 1.247, 95% CI: 1.003– 1.553; Q4 OR: 1.688, 95% CI: 1.344– 2.124). The restricted cubic spline indicated a non-linear association between UA and CI-AKI in middle and elder age groups but a linear association in the young age group.Conclusion: The association between uric acid and CI-AKI vary in patients of different age. Patients with elder age should maintain a middle level of uric acid while patients with middle age should consider a lower level of uric acid to reduce the risk of CI-AKI. The level of UA was an insignificant risk factor for CI-AKI in young patients.Keywords: uric acid, coronary angiography, CI-AKI, age-related

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