Alia H. Abd El Fatah, Mohamed M.Y. Khaled, Mohammed S. Sayed, Mohamed A. Fakher, Sherif R.A. Mohamed
{"title":"无症状高尿酸血症和粘菌素诱导的呼吸机相关性肺炎危重患者急性肾损伤的风险","authors":"Alia H. Abd El Fatah, Mohamed M.Y. Khaled, Mohammed S. Sayed, Mohamed A. Fakher, Sherif R.A. Mohamed","doi":"10.1016/j.ejr.2025.07.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Hyperuricemia has been associated with many chronic metabolic diseases, such as cardiovascular disease, chronic kidney disease, and metabolic syndrome.</div></div><div><h3>Aim of the work</h3><div>To reveal the risk of hyperuricemia and its association with development of acute kidney injury (AKI) during treatment with colistin incritically-illpatients with multidrug and extensive drug resistant ventilator-associated pneumonia not known to be hyperuricemic.</div></div><div><h3>Patients and methods</h3><div>This study included 60 patients with ventilator-associated pneumonia admitted to the intensive care unit (ICU): 23 with hyperuricemia and 37with normal serum uric acid (SUA) levels. The APACHE II (Acute Physiology And Chronic Health Evaluation) and Sequential Organ Failure Assessment (SOFA) were scored. All patients were receiving intravenous colistin 2.5–5 mg/kg/d in 2–4 divided doses.</div></div><div><h3>Results</h3><div>The mean age of the patients was 61.3 ± 14.4 years, 17 females (F:M 1:2.19), the APACHE II and SOFA were lower in those with hyperuricemia (20.5 ± 6.3 and 16.0 ± 4.9) compared to those with normal SUA (24.8 ± 9.3 and 8.7 ± 5.6; p = 0.0.04 and p = 0.001). 12 (52.1 %) patients with hyperuricemia developed AKI and 11 (47.8 %) died while 5 (13.5 %) developed AKI and 17 (45.9 %) died in those with normal SUA (p = 0.001 and p = 0.89 respectively). The area under the curve (AUC) for SUA levels predicting AKI was 0.77 (95 %CI:0.62–0.9) at > 7 mg/dL (sensitivity 71 %, specificity 77 %) (p = 0.001).</div></div><div><h3>Conclusion</h3><div>Asymptomatic hyperuricemia is a potential risk factor for AKI in critically-ill patients with multidrug resistant ventilator-associated pneumonia. It may play a role in the development of sepsis-related AKI, and managing hyperuricemia could potentially serve as an effective strategy to prevent its development.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 197-200"},"PeriodicalIF":1.0000,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Asymptomatic hyperuricemia and the risk of colistin-induced acute kidney injury in critically-ill patients with ventilator-associated pneumonia\",\"authors\":\"Alia H. Abd El Fatah, Mohamed M.Y. Khaled, Mohammed S. Sayed, Mohamed A. Fakher, Sherif R.A. Mohamed\",\"doi\":\"10.1016/j.ejr.2025.07.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Hyperuricemia has been associated with many chronic metabolic diseases, such as cardiovascular disease, chronic kidney disease, and metabolic syndrome.</div></div><div><h3>Aim of the work</h3><div>To reveal the risk of hyperuricemia and its association with development of acute kidney injury (AKI) during treatment with colistin incritically-illpatients with multidrug and extensive drug resistant ventilator-associated pneumonia not known to be hyperuricemic.</div></div><div><h3>Patients and methods</h3><div>This study included 60 patients with ventilator-associated pneumonia admitted to the intensive care unit (ICU): 23 with hyperuricemia and 37with normal serum uric acid (SUA) levels. The APACHE II (Acute Physiology And Chronic Health Evaluation) and Sequential Organ Failure Assessment (SOFA) were scored. All patients were receiving intravenous colistin 2.5–5 mg/kg/d in 2–4 divided doses.</div></div><div><h3>Results</h3><div>The mean age of the patients was 61.3 ± 14.4 years, 17 females (F:M 1:2.19), the APACHE II and SOFA were lower in those with hyperuricemia (20.5 ± 6.3 and 16.0 ± 4.9) compared to those with normal SUA (24.8 ± 9.3 and 8.7 ± 5.6; p = 0.0.04 and p = 0.001). 12 (52.1 %) patients with hyperuricemia developed AKI and 11 (47.8 %) died while 5 (13.5 %) developed AKI and 17 (45.9 %) died in those with normal SUA (p = 0.001 and p = 0.89 respectively). The area under the curve (AUC) for SUA levels predicting AKI was 0.77 (95 %CI:0.62–0.9) at > 7 mg/dL (sensitivity 71 %, specificity 77 %) (p = 0.001).</div></div><div><h3>Conclusion</h3><div>Asymptomatic hyperuricemia is a potential risk factor for AKI in critically-ill patients with multidrug resistant ventilator-associated pneumonia. It may play a role in the development of sepsis-related AKI, and managing hyperuricemia could potentially serve as an effective strategy to prevent its development.</div></div>\",\"PeriodicalId\":46152,\"journal\":{\"name\":\"Egyptian Rheumatologist\",\"volume\":\"47 4\",\"pages\":\"Pages 197-200\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-07-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Egyptian Rheumatologist\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1110116425000390\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Egyptian Rheumatologist","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1110116425000390","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
Asymptomatic hyperuricemia and the risk of colistin-induced acute kidney injury in critically-ill patients with ventilator-associated pneumonia
Background
Hyperuricemia has been associated with many chronic metabolic diseases, such as cardiovascular disease, chronic kidney disease, and metabolic syndrome.
Aim of the work
To reveal the risk of hyperuricemia and its association with development of acute kidney injury (AKI) during treatment with colistin incritically-illpatients with multidrug and extensive drug resistant ventilator-associated pneumonia not known to be hyperuricemic.
Patients and methods
This study included 60 patients with ventilator-associated pneumonia admitted to the intensive care unit (ICU): 23 with hyperuricemia and 37with normal serum uric acid (SUA) levels. The APACHE II (Acute Physiology And Chronic Health Evaluation) and Sequential Organ Failure Assessment (SOFA) were scored. All patients were receiving intravenous colistin 2.5–5 mg/kg/d in 2–4 divided doses.
Results
The mean age of the patients was 61.3 ± 14.4 years, 17 females (F:M 1:2.19), the APACHE II and SOFA were lower in those with hyperuricemia (20.5 ± 6.3 and 16.0 ± 4.9) compared to those with normal SUA (24.8 ± 9.3 and 8.7 ± 5.6; p = 0.0.04 and p = 0.001). 12 (52.1 %) patients with hyperuricemia developed AKI and 11 (47.8 %) died while 5 (13.5 %) developed AKI and 17 (45.9 %) died in those with normal SUA (p = 0.001 and p = 0.89 respectively). The area under the curve (AUC) for SUA levels predicting AKI was 0.77 (95 %CI:0.62–0.9) at > 7 mg/dL (sensitivity 71 %, specificity 77 %) (p = 0.001).
Conclusion
Asymptomatic hyperuricemia is a potential risk factor for AKI in critically-ill patients with multidrug resistant ventilator-associated pneumonia. It may play a role in the development of sepsis-related AKI, and managing hyperuricemia could potentially serve as an effective strategy to prevent its development.