The relationship between serum levels of uric acid and prognosis of infection in critically ill patients Original paper
Researched by:
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Dr. Umar
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Dr. Umar
Read MoreClinical Pharmacist and Clinical Pharmacy Master’s candidate focused on antibiotic stewardship, AI-driven pharmacy practice, and research that strengthens safe and effective medication use. Experience spans digital health research with Bloomsbury Health (London), pharmacovigilance in patient support programs, and behavioral approaches to mental health care. Published work includes studies on antibiotic use and awareness, AI applications in medicine, postpartum depression management, and patient safety reporting. Developer of an AI-based clinical decision support system designed to enhance antimicrobial stewardship and optimize therapeutic outcomes.
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Metals
Metals
Heavy metals play a significant and multifaceted role in the pathogenicity of microbial species.
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Dr. Umar
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Researched by:
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Dr. Umar
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Dr. Umar
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Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Dr. Umar
What was studied?
The relationship between serum uric acid and the prognosis of infection in critically ill patients was examined in this retrospective study, which evaluated serum uric acid levels within 24 hours of ICU admission. The study examined the relationship between the focus keyphrase serum uric acid prognosis and clinical outcomes, as well as organ-related biomarkers such as serum creatinine and blood urea nitrogen. The research further assessed how uric acid varied across different infection types and comorbidities, and whether alterations in uric acid reflected a meaningful microbial or host-response signal in severe infection. Page 1 of the manuscript shows that uric acid was studied as both an oxidative stress–related molecule and a marker influenced by purine metabolism, renal excretion, endothelial injury, and infection-associated inflammatory pathways. Study figures demonstrate linear associations between uric acid and creatinine or BUN, reinforcing its value as a metabolic–renal indicator rather than a direct infection prognosticator.
Who was studied?
A total of 471 critically ill adults admitted to the ICU of Huashan Hospital (Shanghai, China) between 2003 and 2010 were included. As detailed on page 2, participants had confirmed single-site or multisite infections—most commonly pneumonia, CNS infection, urinary tract infection, or sepsis. Comorbidities such as diabetes, hypertension, renal insufficiency, and cerebral infarction were frequent, influencing baseline uric acid values. The cohort had a median age of 57 years, and nearly two-thirds were male. Prognostic outcomes ranged from complete recovery to death, allowing comparison of uric acid levels across clinical trajectories.
Most important findings
Study results showed no direct statistical association between initial serum uric acid levels and prognosis of infection after adjusting for confounders. Study indicates that while unadjusted analyses suggested a correlation, removing patients with renal dysfunction, trauma, erythrocytosis, and CNS infection eliminated prognostic significance. Importantly, uric acid strongly correlated with creatinine and BUN, suggesting renal function and protein metabolism drive its variability. From a microbiome-related perspective, uric acid reflects systemic oxidative stress and metabolic shifts common in severe infection, but it is not a microbial biomarker and does not directly correlate with pathogen-specific patterns. However, because uric acid can modulate inflammatory responses—promoting cytokine production and interacting with endothelial pathways—its fluctuations may indirectly reflect host–microbiome interactions mediated by systemic inflammation, renal perfusion, and metabolic stress.
| Finding | Interpretation |
|---|---|
| Uric acid correlated with creatinine | Indicates renal function is a key driver of serum uric acid variation |
| Uric acid correlated with BUN | Links uric acid to protein metabolism and catabolic stress |
| No adjusted link to prognosis | Uric acid is not a reliable independent predictor of infection outcome |
| High levels in CNS infection, trauma | Reflect metabolic stress rather than microbial signatures |
Key implications
The study suggests that serum uric acid is not an independent prognostic biomarker for infection in critically ill patients. Instead, its fluctuations appear to mirror renal impairment, oxidative stress, and metabolic disturbance. For microbiome-focused clinicians, uric acid lacks clear microbial specificity and should not be interpreted as part of a microbiome-derived signature. Rather, it acts as an indirect indicator of host physiological stress. Future research integrating metabolomics, microbiome profiling, and cytokine mapping may clarify whether uric acid interacts with microbial metabolic pathways in severe infection, but current evidence does not support its use as a standalone prognostic tool.
Citation
Zhu HC, Cao RL. The relationship between serum levels of uric acid and prognosis of infection in critically ill patients. World J Emerg Med. 2012;3(3):186-190