Impact Of Pre-operative Hyperuricemia On Acute Kidney Injury After Cardiac Surgery With Cardiopulmonary Bypass

Objective: To investigate the impact of pre-operative hyperuricemia on acute kidney injury(AKI)after cardiac surgery with cardiopulmonary bypass.Methods: A retrospective cohort study was conducted to analyze the relationship between pre-operative hyperuricemia and post-operative AKI.The clinical data were collected from patients undergoing cardiac surgery with cardiopulmonary bypass in the First Affiliated Hospital of Guangxi Medical University during March 2016 to August 2017.The patients were divided into hyperuricemia group and non-hyperuricemia group according to pre-operative serum uric acid,and AKI was diagnosed according to KDIGO criteria.The incidence of AKI in two groups were compared.Binary stepwise logistic regression analysis was used to evaluate the relationship between pre-operative hyperuricemia and the incidence of AKI.Results: Among 567 patients,217 cases(38.27%)developed AKI after cardiac surgery with cardiopulmonary bypass.There were significant differences in the incidence of AKI between hyperuricemia group and non-hyperuricemia group(44.55% vs 31.06%,P=0.001).The duration of ICU stay and the length of stay were longer in hyperuricemia group than in non-hyperuricemia group(P<0.05).After adjusted for age,gender,co-morbidities(hypertension,diabetes mellitus,cerebrovascular disease),pre-operative renal function,pre-operative heart function,the cardiopulmonary bypass time and post-operative hypotension,Binary stepwise logistic regression analysis showed that pre-operative hyperuricemia was an independent risk factor of AKI after cardiac surgery with cardiopulmonary bypass(OR=1.588,95%CI 1.053~2.395,P=0.027).Conclusion: Pre-operative hyperuricemia is associated with the incidence of AKI after cardiac surgery with cardiopulmonary bypass and the former is an independent risk factor of AKI after cardiac surgery with cardiopulmonary bypass.