Hyperuricemia at 1 year after renal transplantation, its prevalence, associated factors, and graft survival.
BACKGROUND
The present study investigated the prevalence and predictors for the development of hyperuricemia within 1 year after transplantation and their associations with genetic polymorphisms and graft outcome in patients taking tacrolimus and mycophenolate mofetil.


METHODS
One hundred twenty-one renal allograft recipients transplanted between January 2001 and March 2009 were studied. Patients with serum uric acid concentrations above 7.0 mg/dL within 1 year after transplantation were defined as having hyperuricemia, and all were treated with allopurinol. Genetic polymorphisms of nitric oxide synthase, angiotensin-converting enzyme, methylenetetrahydrofolate reductase, and 3 uric acid transporters were examined.


RESULTS
At 1 year after transplantation, 46 (38%) recipients developed hyperuricemia. Male gender, higher body mass index, long-term pretransplantation dialysis, and hypertension were associated with the development of hyperuricemia. The estimated glomerular filtration rate (eGFR) at 1 year after transplantation was lower in the patients with hyperuricemia than in those without. There were no differences in graft survival between the two groups. The pharmacokinetics of tacrolimus and mycophenolic acid and 6 polymorphisms were not associated with hyperuricemia. In the multivariate analysis, male gender, long-term pretransplantation dialysis (>36 months), and eGFR (<60 mL/min) were independently associated with the development of hyperuricemia.


CONCLUSIONS
The incidence of hyperuricemia in our cohort was 38%. Male gender and long-term pretransplantation dialysis were predictors for the development of hyperuricemia. The eGFR was lower in patients with hyperuricemia, but graft survival did not differ between the patients with hyperuricemia treated with alloprinol and those without hyperuricemia. We could not define the significance of the pharmacokinetics of immunosuppressants and genetic risk factors for hyperuricemia.
Department of Urology, Akita University School of Medicine, Akita, Japan.
Kazuyuki
K
Numakura
Shigeru
S
Satoh
Norihiko
N
Tsuchiya
Mitsuru
M
Saito
Shinya
S
Maita
Takashi
T
Obara
Hiroshi
H
Tsuruta
Takamitsu
T
Inoue
Shintaro
S
Narita
Yohei
Y
Horikawa
Hideaki
H
Kagaya
Masatomo
M
Miura
Tomonori
T
Habuchi
D000328:Adult; D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use; D005260:Female; D005838:Genotype; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D033461:Hyperuricemia / Q000453:epidemiology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D052250:Nitric Oxide Synthase Type III / Q000235:genetics; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D013997:Time Factors; D014527:Uric Acid / Q000097:blood
D010281:Parathyroid Hormone; D014527:Uric Acid; D000493:Allopurinol; C496314:NOS3 protein, human; D052250:Nitric Oxide Synthase Type III