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尿酸是肾移植受者移植肾功能障碍的预测因素吗?

Is uric acid a predictive factor for graft dysfunction in renal transplant recipients?

作者信息

Akgul A, Bilgic A, Ibis A, Ozdemir F N, Arat Z, Haberal M

机构信息

Department of Nephrology, Baskent University Hospital, Ankara, Turkey.

出版信息

Transplant Proc. 2007 May;39(4):1023-6. doi: 10.1016/j.transproceed.2007.03.028.

Abstract

Hyperuricemia is a common complication in renal transplant recipients, and uric acid (UA) may play a role in renal dysfunction. The aim of this study was to evaluate the effects of UA on chronic allograft nephropathy (CAN) in renal transplant recipients. The 133 study subjects included 34 women and 99 men of overall mean age of 34.7 +/- 9.9 years. They underwent renal transplantation between 1998 and 2000. Serum UA levels were measured in the first month after transplantation and then at yearly intervals throughout a 3-year follow-up. In the first month after transplantation, 55.3% of recipients had hyperuricemia (UA >7 mg/dL in men; UA >6 mg/dL in women), but, 3 years after transplantation, 84.6% of the subjects had that disorder (P<.001). CAN was diagnosed in 31.5% of the patients at a mean onset of 31.8 +/- 14.3 months after transplantation. Fifty-two percent of these individuals experienced graft failure within 43.3 +/- 20.8 months after transplantation. UA levels were recorded before the development of CAN. There was no association between UA levels and CAN according to a Cox regression analysis (P>.05; relative risk, 1.082; 95% confidence interval [CI] 0.9-1.3). We concluded that the prevalence of hyperuricemia was higher among recipients than in healthy individuals, but that the UA level did not affect the development of CAN during first 3 years after transplantation.

摘要

高尿酸血症是肾移植受者常见的并发症,尿酸(UA)可能在肾功能障碍中起作用。本研究的目的是评估UA对肾移植受者慢性移植肾肾病(CAN)的影响。133名研究对象包括34名女性和99名男性,总体平均年龄为34.7±9.9岁。他们在1998年至2000年期间接受了肾移植。在移植后的第一个月测量血清UA水平,然后在3年的随访期间每年测量一次。移植后的第一个月,55.3%的受者患有高尿酸血症(男性UA>7mg/dL;女性UA>6mg/dL),但移植后3年,84.6%的受试者患有该疾病(P<0.001)。31.5%的患者在移植后平均31.8±14.3个月被诊断为CAN。其中52%的个体在移植后43.3±20.8个月内出现移植肾失功。在CAN发生前记录UA水平。根据Cox回归分析,UA水平与CAN之间无关联(P>0.05;相对风险,1.082;95%置信区间[CI]0.9 - 1.3)。我们得出结论,高尿酸血症在受者中的患病率高于健康个体,但UA水平在移植后的前3年不影响CAN的发生。

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