Background: While hyperuricemia has been widely studied in cardiovascular and renal diseases, the prognostic impact of low serum uric acid (UA) remains unclear. Emerging evidence suggests hypouricemia may be linked to increased mortality and adverse outcomes. This study aimed to assess the relationship between low UA levels and poor outcomes, including mortality and intensive care unit (ICU) admission, in hospitalized patients. Methods: This retrospective cohort study included 1679 hospitalized patients (744 females, 935 males) from the Internal Medicine Clinic. Patients were categorized into normal and low UA groups based on sex-specific thresholds (male: <3.4 mg/dL, female: <2.4 mg/dL). The primary outcome was in-hospital mortality; secondary outcomes were ICU admission and discharge status. Logistic regression models adjusted for age, chronic kidney disease (CKD), hypertension (HT), and coronary artery disease (CAD). A Prognostic Uric Acid Score (PUAS) was developed using significant predictors and evaluated by Receiver Operating Characteristic (ROC) analysis. Results: Low UA levels were significantly associated with higher ICU admission and mortality (p = 0.012). Multivariate analysis identified age (OR: 1.032), low UA (OR: 2.285), and CKD (OR: 1.571) as predictors of poor prognosis. PUAS showed moderate performance (AUC: 0.664), with a cutoff score of 3.5 optimizing sensitivity and specificity. Conclusions: Low UA levels independently predict mortality and poor prognosis in hospitalized patients. These findings support routine UA monitoring and suggest hypouricemia may be a useful prognostic biomarker. Further studies are needed to understand clinical implications and guide UA-targeted interventions.

Background/Objectives: Beyond glycemic control, oral antidiabetic drugs (OADs) may exert class-specific effects on muscle mass and hematologic parameters. However, real-world evidence comparing these effects across OAD classes remains limited. This study aimed to evaluate the differential effects of commonly prescribed OADs on skeletal muscle mass (SMM) and hemoglobin (Hb) levels in adults with type 2 diabetes mellitus (T2DM). Methods: In this prospective observational cohort study, 60 adults with newly initiated OAD therapy were followed for six months at a tertiary care center in Türkiye. Patients were classified according to the OAD class newly added to their regimen (metformin, sulfonylureas, dipeptidyl peptidase-4 inhibitors, pioglitazone, or sodium–glucose cotransporter-2 inhibitors [SGLT2-i]). Multi-frequency bioelectrical impedance analysis was used to evaluate body composition, and hematologic parameters including Hb were obtained at both time points. To account for potential confounders—including age, sex, BMI, baseline Hb, and eGFR—binary logistic regression analyses were performed. Results: Patients initiated on pioglitazone (n = 11) demonstrated a borderline within-group increase in SMM in unadjusted analysis (median delta +0.17 kg, IQR −0.55 to +0.50; p = 0.050); however, this association was attenuated and no longer statistically significant after multivariable adjustment (OR 2.16, 95% CI 0.60–7.83; p = 0.240). In contrast, SGLT2-i users (n = 28) showed a significant increase in Hb (median delta +0.10 g/dL, IQR −0.30 to +0.50; p = 0.022), which remained significant after adjustment (OR 4.22, 95% CI 1.32–13.44; p = 0.015). Other OAD classes were not associated with meaningful changes in SMM or Hb. Conclusions: In this real-world prospective cohort, pioglitazone showed a trend toward increased SMM in unadjusted analysis that did not reach significance after adjustment, suggesting a hypothesis-generating signal warranting further investigation. SGLT2 inhibitors were independently associated with increased Hb levels, though the observed median increment was modest in absolute terms. These findings highlight potentially clinically relevant, non-glycemic effects of OAD classes and may inform individualized treatment selection, particularly in patients at risk of sarcopenia or anemia. Adequately powered, prospective studies are needed to validate and extend these preliminary observations.

Background: This study aimed to evaluate the long-term kidney outcomes of patients hospitalized with COVID-19 by comparing those who developed acute kidney injury (AKI) during hospitalization with those who did not. Methods: Among 3472 patients hospitalized with COVID-19, 95 patients who developed AKI and had follow-up creatinine measurements for at least 3 months were included. A control group of 370 patients without AKI during hospitalization was also analyzed. Kidney function outcomes were evaluated using serum creatinine, estimated glomerular filtration rate (eGFR), and the incidence of chronic kidney disease (CKD) at follow-up. Results: Patients who developed AKI were significantly older and had higher creatinine levels at admission. At a median follow-up of approximately 5 months, follow-up creatinine levels and delta creatinine were significantly higher in the AKI group compared with patients without AKI (P < .001). Correspondingly, eGFR declined more markedly in patients with AKI. Overall, CKD developed in 16.1% of patients at follow-up and was significantly more frequent among those who experienced AKI during hospitalization. In multivariate analysis, AKI remained an independent predictor of persistent kidney dysfunction. Conclusion: The COVID-19 patients who develop AKI during hospitalization are at increased risk of persistent kidney dysfunction and CKD after discharge. These findings highlight the importance of long-term kidney monitoring in this patient population. Cite this article as: Halıcı Zavalsız N, Çiftçi Öztürk E, Cebeci E, Ziyadanoğlu P, Öztürk S. Evaluation of long-term kidney functions of patients developing hospital-associated acute kidney injury during COVID-19 infection. Turk J Nephrol. 2026;35(3):216-223.