Front Mol Biosci. 2025 Jun 18;12:1635227. doi: 10.3389/fmolb.2025.1635227. eCollection 2025.
ABSTRACT
BACKGROUND: Acute kidney injury (AKI) is a serious clinical syndrome, with elevated serum uric acid (SUA) recognized as a potential modifiable risk factor. Nonetheless, the association between reduced SUA and the risk of AKI, along with the modification by kidney function on this association, is not well understood.
METHODS: All adult patients from Peking University First Hospital (PKUFH) were screened. The primary outcome was AKI during hospitalization. Restricted cubic spline (RCS) was utilized to examine the hypothesized non-linearity between AKI and SUA as a continuous variable. SUA was categorized into six groups and Poisson regression was applied to evaluate the association between SUA groups and AKI with 240-360 μmol/L as reference. Subgroup analysis was conducted in terms of estimated glomerular filtration rate (eGFR).
RESULTS: Among 62,775 patients enrolled from PKUFH, 1,866 patients developed AKI (3.0%). The RCS plot showed a U-shaped association between SUA and AKI. Compared with reference group, SUA ≤ 180 μmol/L and >480 μmol/L exhibited a 2.17-fold and a 4.86-fold increased risk of AKI in the unadjusted model. After full adjustment, the associated risk of AKI in SUA ≤ 180 μmol/L (RR 1.92, 95% CI 1.57-2.36) and SUA > 480 μmol/L (RR 1.17, 95% CI 1.03-1.34) was weakened but still demonstrated statistical significance. When stratified by eGFR, the U-shaped risk curve was much less steep in the subgroup with eGFR ≤ 45 mL/min/1.73 m2.
CONCLUSION: This study reveals a U-shaped association between admission SUA and AKI risk. Kidney function is an important confounder for this association.
PMID:40607059 | PMC:PMC12213346 | DOI:10.3389/fmolb.2025.1635227
