Clin Exp Emerg Med.  2021 Jun;8(2):82-88. 10.15441/ceem.20.024.

Uric acid albumin ratio as a predictive marker of short-term mortality in patients with acute kidney injury

• Özgür Y
• Akın S
• Yılmaz NG
• Gücün M
• Keskin

• KMID: 2517603
• DOI: http://doi.org/10.15441/ceem.20.024

Abstract

Objective
We aimed to investigate uric acid and albumin ratio (UA/A) as a marker of short-term mortality in acute kidney injury (AKI). Both uric acid and albumin are strongly correlated with the development and mortality of AKI.
Methods
The patients hospitalized from May 2019 to September 2019 for AKI were included in this study. The diagnostic odds ratio (DOR), Youden index (J), and the area under a receiver operating characteristic curve (AUROC) determined a cut-off UA/A ratio for mortality. Cox-regression analysis was performed to identify UA/A as a prognostic marker of the 30-day mortality rate.
Results
A total of 171 patients with an average age of 69.20±13.0 (45.6% women) were included in the study. The average UA/A ratio was 3.3±1.5 mg/g and 2.5±1.0 mg/g in the non-survivor and survivor groups, respectively (P=0.001). The best cut-off UA/A ratio associated with mortality was determined as 2.4 mg/g with a specificity of 52% and a sensitivity of 77% (DOR, 3.6; J, 28.8; AUROC, 0.644). Thirty-day cumulative survival rates of the low and high UA/A ratio groups were 85.9±4.0% and 63.7±5.0%, respectively. The estimated survival times of the low and high UA/A ratio groups were 27.7 days (95% confidence interval [CI], 26.2–29.3) and 23.9 days (95% Cl, 22.0–25.9), respectively.
Conclusion
We found a direct correlation between 30-day mortality and UA/A ratio at initial presentation in AKI patients regardless of age, comorbidities, and clinical and laboratory findings, including albuminuria.

Keyword

Acute kidney injury; Uric acid; Serum albumin; Hypoalbuminemia; Hyperuricemia