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 months. In 210 included participants, each 100 mg*hour/dL increase in 24 h AUC was associated with an average decline in eGFR at hospital dismissal of 9% (95%CI 3, 15) in univariate analysis. Each 100 mg*hour/dL increase in 24 h AUC was independently associated with an average decline in eGFR of 8% (95%CI 2, 13) at 1 month 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.

Keywords:

• Uric acid
• tumor lysis syndrome
• acute kidney injury
• lymphoma and Hodgkin disease
• rasburicase

Disclosure statement

All authors declare no competing interest related to the content of this work. Dr. Erin Barreto is a consultant for FAST Biomedical (unrelated).

Additional information

Funding

This project was supported in part by CTSA Grant Number UL1 TR002377 from the National Center for Advancing Translational Science (NCATS), the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under Award Number K23AI143882 (PI; EFB) and the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG034676. The contents of this work are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute of Health. This project was also supported, in part, by a small grant from the Mayo Midwest Pharmacy Research Committee.