Serum uric acid level as a marker for mortality and acute kidney injury in patients with acute paraquat intoxication

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2011-06, Vol.26 (6), p.1846-1852
• Main Authors: KIM, Jung-Hoon, GIL, Hyo-Wook, YANG, Jong-Oh, LEE, Eun-Young, HONG, Sae-Yong
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - blood; Acute Kidney Injury - chemically induced; Acute Kidney Injury - mortality; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Biomarkers - blood; Emergency and intensive care: renal failure. Dialysis management; Female; Glomerular Filtration Rate; Herbicides - blood; Herbicides - poisoning; Humans; Intensive care medicine; Male; Medical sciences; Middle Aged; Paraquat - blood; Paraquat - poisoning; Prognosis; Reactive Oxygen Species - metabolism; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Uric Acid - blood
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfq632

Paraquat (PQ) is a non-selective herbicide that generates reactive oxygen species (ROS) in vivo. Uric acid emerged as a marker of oxidative stress and may enhance ROS-mediated injury in acute PQ intoxication. Therefore, we investigated the association between uric acid levels and mortality and acute kidney injury (AKI) in the present study. From January 2007 to December 2008, patients who arrived at our hospital with acute PQ intoxication (n = 513) were included in the study. Patients were divided into two groups (hyperuricaemia vs non-hyperuricaemia) based on uric acid levels. Mortality and AKI were analysed in reference to uric acid level. Patient mortality was higher in the hyperuricaemia group than the non-hyperuricaemia group (68.4% vs 38.3%, P < 0.05). The incidence of AKI and kidney failure was 64% and 43.3%, respectively. Hyperuricaemia increased the risk of mortality and kidney failure to 3.7- and 3.3-fold after adjustments for age, sex and the estimated amounts of PQ ingestion. Mean serum uric acid level was higher in death group than survival group and higher in kidney failure group than non-AKI group and non-failure group. Baseline serum uric acid level might be a good clinical marker for patients at risk of mortality and AKI after acute PQ intoxication.