PREOPERATIF SERUM URIC ACID LEVELS PREDICT ACUTE KIDNEY INJURY AFTER CARDIAC SURGERY.

Abstract

Background: Cardiac surgery has been associated with impaired renal parenchymal function precisely in the tubular system. This causes Acute Kidney Injury (AKI), which started from the operation and persisted to postoperative in various time span. This decrease in kidney function leads to the accumulation of residual plasma products, such as urea and creatinine. Concentrations of uric acid may be associated with kidney disease without intrarenal uric acid crystal deposition. Additionally, hyperuricemia associated directly with hypertension, metabolic syndrome, chronic kidney disease, and peripheral vascular disease. Moreover, hyperuricemia is a common finding in patients with coronary vascular disease. Thus, preoperative hyperuricemia may be linked to an increased risk of AKI after CABG. This study aims to determine the level of preoperative uric acid serum can predict the incidence of Cardiac Surgery-Associated AKI (CSA-AKI) at the Haji Adam Malik General Hospital.

Methods: This retrospective cohort study of 100 patients underwent coronary artery bypass graft (CABG) at the Haji Adam Malik General Hospital from January 2019 to December 2019. All patients will be examined for preoperative and postoperative laboratory. For serum uric acid values will be divided into 2 groups, namely group 1, namely patients with serum uric acid levels <6.5 g / dL (normal), and group 2 with serum uric acid levels> 6.5 g/dL (Hyperuricemia). Then the patient will be followed during hospitalization. Then conducted analysis to see association between serum uric acid level and incidence of CSA-AKI.

Results: The highest incidence of postoperative coronary artery surgeries occurred in the serum level of uric acid in group 2 compared to group 1. In group 2 the incidence of postoperative AKI was 39 people (59.1%) while in group 1 there were 9 people (25.6% ) with a P-value of 0.002. Multivariate analysis showed that uric acid >6.5 g/dL was the most dominant risk factor affecting the incidence of postoperative AKI [OR 3.69 (1.19-11.43), p = 0.023].

Conclusion: A high serum uric acid level (> 6.5 g/dL) is a strong predictor of the incidence of postoperative AKI in coronary artery bypass surgery with an OR of 3.69.