Elevated serum uric acid after injury correlates with the early acute kidney in severe burns

Burns. 2015 Dec;41(8):1724-1731. doi: 10.1016/j.burns.2015.09.001. Epub 2015 Oct 3.

Abstract

Objective: Early acute kidney injury (AKI) is one of the most serious and common complications in the early stage of severe burns, but the pathological mechanisms still need to be elucidated. High uric acid (UA) has been found to be correlated with renal dysfunction in some experimental and clinical studies; however, the study of the dynamic correlation between AKI and UA in severe burns is still lacking.

Methods: The diagnosis and classification of AKI were performed according to RIFLE criteria, UA, serum creatinine (Scr), estimated glomerular filtration rate (eGFR), C-reactive protein (CRP) and lactic acid (LA) were dynamically monitored within 2 days after injury in 59 severely burned patients.

Results: Within 2 days after injury, AKI occurred in 23 of 59 patients (risk in 12 cases, injury in seven cases and failure in four cases), UA level in AKI patients was significantly higher than that in No-AKI patients, and referring to the cutoff level of UA (375.5 μmol/l) from ROC curve for predicting AKI, the abnormal increase of UA levels was earlier than acute deterioration of renal function in most of the AKI patients after injury. Among AKI patients, the Scr/eGFR levels were closely related to UA levels for 2 days after injury. Moreover, UA level in cases with severe grade of AKI was significantly higher than that in those with less severe grade of AKI. Furthermore, there was a positive correlation between UA and CRP for 2 days after injury in AKI patients, and a significant correlation between CRP and Scr/eGFR was found 1 day after injury. The positive correlation was also found between LA and UA after injury in AKI patients.

Conclusion: The results suggest that elevated serum UA after injury due to hypoxia is closely correlated with early AKI after severe burns, and UA-related aberrant inflammation also appears to be one of the pathogenic factors, providing the useful information for potential therapy.

Keywords: Acute kidney injury; C-reactive protein; Lactic acid; Severe burns; Uric acid.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • APACHE
  • Acute Kidney Injury / blood*
  • Acute Kidney Injury / epidemiology
  • Adult
  • Body Surface Area
  • Burns / blood*
  • Burns / epidemiology
  • C-Reactive Protein / metabolism
  • Cohort Studies
  • Creatinine / blood
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hypoxia / blood*
  • Hypoxia / epidemiology
  • Lactic Acid / blood
  • Male
  • Middle Aged
  • Prospective Studies
  • ROC Curve
  • Trauma Severity Indices
  • Uric Acid / blood*

Substances

  • Uric Acid
  • Lactic Acid
  • C-Reactive Protein
  • Creatinine