Risk Factors of Hyperuricemia After Renal Transplantation and Its Long-term Effects on Graft Functions.
BACKGROUND
Hyperuricemia is a common complication in renal transplant recipients. Recent studies have suggested that hyperuricemia may contribute to the deterioration of graft function.


METHODS
In this study, we aimed to investigate the risk factors related to hyperuricemia and the effects of hyperuricemia on graft dysfunction, graft survival, cardiovascular events, and mortality rates. Between the years 2005 and 2016, 141 renal transplantation patients with at least 5 years of follow-up were included in this retrospective cohort study. Multi-linear regression analysis was used to determine the relationship between mean serum uric acid level and estimated glomerular filtration rate (eGFR).


RESULTS
The average transplant age was 37.1 ± 12.1 years and the average follow-up time was 83.09 ± 20.30 months; the prevalence of patients with hyperuricemia was 39 (27.6%). The mean uric acid levels were higher in women (P < .001) in the condition of dyslipidemia (P = .026), β-blocker usage (P = .002), and thiazide diuretics (P = .020). Patients with hyperuricemia (P < .001), new-onset hypertension (P = .027), β-blocker usage (P = .005), and thiazide diuretics (P = .040) had statistically different eGFR levels than other recipients. Multivariant regression analyses showed that eGFR levels after transplantation were correlated with mean uric acid levels (β = -0.46, P = .001), donor age (β = -0.18, P = .048), recipient age (β = -0.28, P = .0003), and mean hemoglobin levels (β = 0.31, P = .003).


CONCLUSIONS
There was no difference in graft loss, general mortality, and cardiovascular events between normo-uricemic and hyperuricemic groups. Increased uric acid levels contribute to eGFR decline in patients with renal transplantation. On the other hand, effects of uric acid levels on graft survival, cardiovascular events, and general mortality are still controversial.
Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey. Electronic address: eyupoglusahn@yahoo.com.
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Eyupoglu
Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
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Eyupoglu
Department of Nephrology, Ankara University School of Medicine, Ankara, Turkey.
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Kendi-Celebi
Department of Nephrology, Ankara University School of Medicine, Ankara, Turkey.
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Akturk
Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey; Transplantation Center, Ankara University School of Medicine, Ankara, Turkey.
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Tuzuner
Department of Nephrology, Ankara University School of Medicine, Ankara, Turkey; Transplantation Center, Ankara University School of Medicine, Ankara, Turkey.
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Keven
Department of Nephrology, Ankara University School of Medicine, Ankara, Turkey; Transplantation Center, Ankara University School of Medicine, Ankara, Turkey.
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Sengul
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D033461:Hyperuricemia / Q000453:epidemiology* / Q000209:etiology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood
D014527:Uric Acid