Kim K M, Kim S-S, Han D J, Yang W S, Park J S, Park S-K
Division of Nephrology, Department of Internation Medicine, Asan Medical Center, Seoul, South Korea.
Transplant Proc. 2010 Nov;42(9):3562-7. doi: 10.1016/j.transproceed.2010.07.104.
The aim of this study was to investigate the prevalence of hyperuricemia and factors predicting its occurrence, and to establish the relationship over time between serial changes in estimated glomerular filtration rate (eGFR) and uric acid (UR) concentration in kidney transplant (KT) recipients with eGFR >60 mL/min/1.73 m(2).
Adult patients who underwent KT at the Asan Medical Center between 1990 and 2008 and maintained eGFR >60 mL/min/1.73 m(2) were retrospectively assessed. Clinical and laboratory data were obtained from inpatient and outpatient charts and from the hospital electronic database.
Of 356 patients, 301 (84.55%) had normal UR levels and 55 (15.45%) had hyperuricemia. After multivariate adjustment, transplant duration, male gender, eGFR, diabetes mellitus (DM), and calcium level were associated with higher mean UR levels. Mean UR level increased significantly and mean eGFR decreased significantly during the first year after transplantation, but there were no significant differences over the next 4 years. Serial UR and eGFR levels changed almost simultaneously.
Transplantation duration, male gender, eGFR level, DM, and serum calcium level were risk factors for hyperuricemia in kidney recipients with intact graft function. Increased uric acid after KT did not significantly affect graft function.
本研究旨在调查肾移植（KT）受者中高尿酸血症的患病率及其发生的预测因素，并确定估算肾小球滤过率（eGFR）>60 mL/min/1.73 m²的肾移植受者中，eGFR与尿酸（UR）浓度的系列变化之间随时间的关系。
对1990年至2008年在峨山医学中心接受肾移植且eGFR>60 mL/min/1.73 m²的成年患者进行回顾性评估。临床和实验室数据来自住院和门诊病历以及医院电子数据库。
356例患者中，301例（84.55%）尿酸水平正常，55例（15.45%）有高尿酸血症。多因素调整后，移植时间、男性性别、eGFR、糖尿病（DM）和钙水平与较高的平均尿酸水平相关。移植后第一年平均尿酸水平显著升高，平均eGFR显著降低，但在接下来的4年中无显著差异。尿酸和eGFR的系列水平几乎同时变化。
移植时间、男性性别、eGFR水平、DM和血清钙水平是移植肾功能正常的肾移植受者发生高尿酸血症的危险因素。肾移植后尿酸升高对移植肾功能无显著影响。
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