Hyperuricemia is associated with the development of the composite outcomes of new cardiovascular events and chronic allograft nephropathy.
BACKGROUND
To investigate the prevalence and the predictors for the development of hyperuricemia at 6 months after kidney transplantation, and its association with clinical outcomes including patient and graft survival, the development of new cardiovascular events and chronic allograft nephropathy (CAN).


METHODS
Adult patients who underwent kidney transplantation at Mount Sinai Medical Center between January 1, 2001 and December 30, 2004 were included in the study. New cardiovascular events and biopsy-proven CAN were investigated.


RESULTS
Of the 307 patients, 163 patients (53%) had normal uric acid levels and 144 patients (47%) had hyperuricemia. After adjustment for age, race, and sex, receiving a cadaveric kidney, having an estimated glomerular filtration rate (eGFR) less than 50 mL/min, and taking diuretics or cyclosporine were associated with hyperuricemia at 6 months after transplantation. Over a mean 4.3 years of follow-up, 83 patients had one, or more, of the events, 4 died, 20 had graft failure, 40 had new cardiovascular events, and 41 developed CAN. Kaplan-Meier survival curves showed that these events occurred more frequently in patients with hyperuricemia (P<0.001). Among transplant recipients with an eGFR less than 50 mL/min, 45% of hyperuricemic and 21% of normouricemic patients had an event (P=0.038). For patients with an eGFR more than 50 mL/min, event rates were similar for patients with and without hyperuricemia, 25.0% vs. 19.4%, respectively.


CONCLUSIONS
These results suggest an important association between hyperuricemia at 6 months after kidney transplantation and new cardiovascular events and CAN in patients with decreased allograft function.
Akalin
Enver
E
Division of Nephrology, Mount Sinai School of Medicine, New York, NY 10029-6574, USA. enver.akalin@msnyuhealth.org
Ganeshan
Sri Venkatesh
SV
Winston
Jonathan
J
Muntner
Paul
P
D000328:Adult; D000368:Aged; D001706:Biopsy; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006085:Graft Survival; D006801:Humans; D033461:Hyperuricemia / Q000453:epidemiology* / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018579:Patient Selection; D011183:Postoperative Complications / Q000097:blood*; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous