CHINESE JOURNAL OF MEDICINAL GUIDE >
The Dual Role of Serum Uric Acid Levels in Sepsis-Associated Acute Kidney Injury
Received date: 2025-02-21
Revised date: 2025-05-21
Accepted date: 2025-11-15
Online published: 2025-12-24
Objective： To investigate the correlation between baseline uric acid levels and the occurrence of sepsis-associated acute kidney injury （SA-AKI）.Methods： A retrospective cohort study was conducted to analyze 571 sepsis patients admitted to our hospital from January 2019 to December 2024. Patients were divided into the hyperuricemia group （n=147） and the non-hyperuricemia group （n=424） based on serum uric acid levels， and the incidence of SA-AKI was compared between the two groups. Multivariate logistic regression was used to analyze the correlation between hyperuricemia and SA-AKI. A restricted cubic spline （RCS） model was applied to assess the nonlinear relationship between uric acid levels and SA-AKI risk.Results： The overall incidence of SA-AKI in sepsis patients was 51.14%. The hyperuricemia group had a significantly higher SA-AKI incidence than the non-hyperuricemia group （76.7% vs. 42.3%， P<0.001）. Intergroup comparisons revealed that， compared to the non-hyperuricemia group， the hyperuricemia group exhibited higher proportions of hypertension， coronary heart disease， baseline chronic kidney disease， and elevated levels of serum creatinine， white blood cells count， lactate levels， and lower baseline eGFR （P<0.05）. Multivariate logistic regression analysis showed that hyperuricemia was an independent risk factor for SA-AKI （OR=4.387， P<0.001）. RCS analysis demonstrated a nonlinear relationship between uric acid levels and SA-AKI risk （P<0.001）. Uric acid levels below 250 μmol·L-1 were negatively correlated with SA-AKI risk， whereas levels above 250 μmol·L-1 were positively correlated.Conclusion： Hyperuricemia is an independent risk factor for SA-AKI， and uric acid has a dual role in the occurrence of SA-AKI. Clinically， monitoring of uric acid levels of sepsis patients should be emphasized to enable early identification and intervention of high-risk populations of SA-AKI.
Key words： Sepsis； ; Hyperuricemia； ; Acute kidney injury； ; Dual role
ZHANG Shuliu, CHEN Yugang, LIU Ruirui, DU Chao, CUI Yunliang
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The Dual Role of Serum Uric Acid Levels in Sepsis-Associated
Acute Kidney Injury
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