Understanding the risk factors for AKI is crucial in preventing and managing this condition

Oct 13, 2025 by wbrum.org 4 views

Serum Level of Preoperative Uric Acid as a Predictor of Acute Kidney Failure (Acute Kidney Injury/Battery) After the Coronary Artery Bypass Grafting (CABG) Surgery

Introduction

Coronary artery bypass grafting (CABG) surgery is a common procedure used to treat coronary artery disease, which can lead to heart failure and even death. However, this surgery also carries a risk of causing damage to the kidney function, especially in the tubular system. This damage can result in acute kidney injury (AKI), also known as battery, which can start during the operation process and continue until postoperatives with varying time spans. Understanding the risk factors for AKI is crucial in preventing and managing this condition.

The Role of Uric Acid in Kidney Disease

Uric acid is a compound that is produced in the body as a byproduct of the breakdown of purines. While uric acid is essential for various bodily functions, high levels of uric acid in the blood, known as hyperuricemia, have been linked to various medical conditions, including hypertension, metabolic syndrome, chronic kidney disease, and peripheral blood vessel disease. In the context of heart disease, hyperuricemia is often found in patients with coronary blood vessel disease, which implies that high uric acid levels before surgery can correlate with an increased risk of post-CABG AKI.

The Study

This study aims to evaluate the significance of the level of preoperative uric acid serum as a predictor of AKI incidence related to cardiac surgery at the General Hospital of Adam Malik Hajj (HAM) Medan. This study uses a retrospective cohort design involving 100 patients undergoing CABG in HAM Hospital between January 2019 and December 2019. All patients were examined for uric acid serum levels and laboratory analysis before and after surgical procedures. To assess uric acid serum levels, patients were divided into two groups: the first group (normal) with levels <6.5 µg/dl, and the second group (hyperuricemia) with levels> 6.5 µg/dl.

Results

The results showed that the postoperative AKI incident was higher in the second group than the first group. Of the total patients in the second group, as many as 39 people (59.1%) experienced postoperative AKI, while in the first group only 9 people (25.6%) experienced similar conditions. With the value of P = 0.002, this result shows a significant relationship between uric acid serum levels and AKI. In addition, multivariate analysis reinforces this finding by showing that uric acid levels> 6.5 µg/dL are dominant risk factors for postoperative AKI with odds ratio (OR) of 3.69 (1.19-11.43), p = 0.023.

Conclusion

The conclusion of this study confirms that the high level of uric acid serum (> 6.5 µg/dL) can be a strong and reliable indicator to predict the incidence of AKI after heart surgery. This shows the need for more attention to the management of patients' uric acid levels before undergoing surgical procedures, especially in groups of patients with high risk. With this understanding, doctors and medical teams can make better prevention efforts to minimize the risk of AKI, increase postoperative recovery, and ultimately increase overall clinical outcomes for patients.

Implications for Clinical Practice

The findings of this study have significant implications for clinical practice. Firstly, it highlights the importance of monitoring uric acid levels in patients undergoing CABG surgery. Secondly, it suggests that patients with high uric acid levels (> 6.5 µg/dL) may require closer monitoring and more aggressive management of their uric acid levels before and after surgery. Finally, it emphasizes the need for healthcare providers to be aware of the risk factors for AKI and to take proactive steps to prevent and manage this condition.

Future Directions

Future studies should aim to replicate the findings of this study and to explore the mechanisms by which uric acid levels affect the risk of AKI. Additionally, studies should investigate the effectiveness of interventions aimed at reducing uric acid levels in patients undergoing CABG surgery. By understanding the relationship between uric acid levels and AKI, healthcare providers can develop more effective strategies to prevent and manage this condition, ultimately improving patient outcomes.

Limitations of the Study

This study has several limitations. Firstly, the sample size was relatively small, which may limit the generalizability of the findings. Secondly, the study was retrospective in design, which may introduce bias. Finally, the study did not control for other potential risk factors for AKI, such as age, sex, and comorbidities. Future studies should aim to address these limitations and to provide more robust evidence for the relationship between uric acid levels and AKI.

Conclusion

In conclusion, this study provides evidence that the level of preoperative uric acid serum is a significant predictor of AKI incidence after CABG surgery. The findings of this study have significant implications for clinical practice and highlight the need for healthcare providers to be aware of the risk factors for AKI and to take proactive steps to prevent and manage this condition. Future studies should aim to replicate the findings of this study and to explore the mechanisms by which uric acid levels affect the risk of AKI.
Frequently Asked Questions (FAQs) About Serum Level of Preoperative Uric Acid as a Predictor of Acute Kidney Failure (Acute Kidney Injury/Battery) After the Coronary Artery Bypass Grafting (CABG) Surgery

Q: What is the significance of uric acid levels in patients undergoing CABG surgery?

A: Uric acid levels are significant in patients undergoing CABG surgery because high levels of uric acid have been linked to an increased risk of acute kidney injury (AKI) after surgery. AKI is a serious complication that can occur during or after CABG surgery, and it can lead to prolonged hospital stays, increased healthcare costs, and even death.

Q: What are the normal and abnormal ranges for uric acid levels?

A: The normal range for uric acid levels is typically considered to be less than 6.5 mg/dL. Abnormal ranges are typically considered to be greater than 6.5 mg/dL, which is associated with an increased risk of AKI.

Q: What are the risk factors for AKI after CABG surgery?

A: The risk factors for AKI after CABG surgery include:

High uric acid levels (> 6.5 mg/dL)
Age
Sex
Comorbidities (such as diabetes, hypertension, and kidney disease)
Surgical complexity
Perioperative fluid management

Q: How can healthcare providers reduce the risk of AKI after CABG surgery?

A: Healthcare providers can reduce the risk of AKI after CABG surgery by:

Monitoring uric acid levels before and after surgery
Managing fluid balance and electrolyte levels
Avoiding nephrotoxic medications
Providing adequate perioperative care
Identifying and managing risk factors for AKI

Q: What are the implications of this study for clinical practice?

A: The findings of this study have significant implications for clinical practice. They highlight the importance of monitoring uric acid levels in patients undergoing CABG surgery and suggest that patients with high uric acid levels (> 6.5 mg/dL) may require closer monitoring and more aggressive management of their uric acid levels before and after surgery.

Q: What are the limitations of this study?

A: The limitations of this study include:

Small sample size
Retrospective design
Lack of control for other potential risk factors for AKI

Q: What are the future directions for research on this topic?

A: Future studies should aim to replicate the findings of this study and to explore the mechanisms by which uric acid levels affect the risk of AKI. Additionally, studies should investigate the effectiveness of interventions aimed at reducing uric acid levels in patients undergoing CABG surgery.

Q: What are the potential benefits of this research for patients?

A: The potential benefits of this research for patients include:

Improved understanding of the risk factors for AKI after CABG surgery
Development of more effective strategies to prevent and manage AKI
Improved patient outcomes, including reduced morbidity and mortality

Q: What are the potential benefits of this research for healthcare providers?

A: The potential benefits of this research for healthcare providers include:

Improved understanding of the risk factors for AKI after CABG surgery
Development of more effective strategies to prevent and manage AKI
Improved patient outcomes, including reduced morbidity and mortality

Q: What are the potential benefits of this research for healthcare systems?

A: The potential benefits of this research for healthcare systems include:

Reduced healthcare costs associated with AKI
Improved patient outcomes, including reduced morbidity and mortality
Development of more effective strategies to prevent and manage AKI.