Relationship between uric acid and kidney function in adults at risk for tumor lysis syndrome.

Abstract

Uric acid drives acute kidney injury in tumor lysis syndrome (TLS). This study investigated the relationship between uric acid and changes in estimated glomerular filtration rate (eGFR) in adults at risk for TLS. Linear regression was used to evaluate the relationship between uric acid area under the curve (AUC) and percent change in eGFR from baseline at hospital dismissal, 1 and 3\u2009months. In 210 included participants, each 100\u2009mg*hour/dL increase in 24\u2009h AUC was associated with an average decline in eGFR at hospital dismissal of 9% (95%CI 3, 15) in univariate analysis. Each 100\u2009mg*hour/dL increase in 24\u2009h AUC was independently associated with an average decline in eGFR of 8% (95%CI 2, 13) at 1\u2009month after dismissal. Additional research is needed to confirm these findings and determine whether treatments that reduce overall uric acid exposure improve kidney outcomes. Preserving kidney health could favorably impact cancer treatment eligibility, tolerability, and outcomes.