The association between hyperuricemia and the risk of acute kidney injury; a systematic review and meta-analysis

Introduction: Acute kidney injury (AKI) is a prevalent clinical syndrome in hospitalized patients associated with uric acid levels in patients. This study aims to evaluate the relationship between hyperuricemia and the risk of AKI using a systematic review and meta-analysis approach. Materials and Methods: This systematic review and meta-analysis was performed based on PRISMA guidelines. A query on international databases, including Cochrane, Web of Science, PubMed, Scopus, and the Google Scholar search engine, was conducted using relevant keywords. The literature search stage was updated until January 2023. Data were analyzed in STATA 14 software. A significance level of P < 0.05 was considered for all tests. Results: A total of 22 articles published from 2006 to 2023 with a sample size of 82469 patients were reviewed. The estimated odds ratio (OR) was 1.96 (95% CI: 1.63, 2.35, P=0.000, I2=89.6%) between hyperuricemia and the risk of AKI and 1.64 (OR: 1.64; 95% CI: 1.23, 2.20, P=0.012, I2=63.2%) between hyperuricemia and AKI mortality and these relationships were statistically significant. In addition, the OR of hyperuricemia and AKI was 1.96 (95% CI: 0.97, 3.98, P=0.000, I2=97.9%) in males and 2.34 (OR: 2.34; 95% CI: 1.14, 4.78, P=0.000, I2=97.9%) in females. The OR of hyperuricemia and AKI was 1.07 (95% CI: 1.03, 1.10) in 30-39 years, 2.37 (95% CI: 1.04, 5.42) in 40-49 years, 4.71 (95% CI: 1.29, 17.20) in 50-59 years, 2.07 (95% CI: 1.58, 2.71) in 60-69 years, and 1.42 (95% CI: 1.04, 1.93) in 70-79 years age groups. Conclusion: Hyperuricemia significantly increases the risk of AKI and mortality. Therefore, by reducing the serum level of uric acid, the risks caused by it can be avoided. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (ID: CRD42023393648).