Objective: One of the common complications of coronary angiography and percutaneous coronary intervention in patients with acute coronary syndrome is contrast-induced nephropathy (CIN). The objective was to determine the predictive value of the uric acid-to-albumin ratio (UAR) in identifying the risk of CIN.

Materials and Methods: A total of 1,437 patients were enrolled in the study. Patients were divided into two groups: those with and those without CIN. Demographic characteristics and laboratory parameters were compared between the groups.

Results: Contrast-induced nephropathy was observed in 242 patients. Diabetes mellitus, hypertension, and atrial fibrillation were more prevalent in this group. Serum uric acid, albumin, and UAR levels differed significantly between the groups. In multivariate analysis, UAR was identified as an independent predictor of CIN (OR= 4.671, p = 0.005). The area under the curve (AUC) of UAR for predicting CIN was 0.930 (95% CI: 0.914–0.947). The optimal cut-off value was 0.164, with a sensitivity of 85.1% and specificity of 87.6% (p < 0.001).

Conclusion: UAR was identified as a significant independent predictor of CIN. Its use in routine practice may be beneficial for early identification of CIN risk before coronary angiography.