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老年肾移植受者与肾功能不全:高尿酸血症的一个危险因素。

Elderly renal transplant recipients and renal dysfunction: a risk factor for hyperuricemia.

作者信息

Einollahi Behzad, Einollahi Hoda, Rostami Zohreh

机构信息

Department of Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

出版信息

Exp Clin Transplant. 2011 Dec;9(6):376-80.

Abstract

OBJECTIVES

To date, limited data are currently available on posttransplant hyperuricemia in elderly renal transplant patients.

MATERIALS AND METHODS

We conducted a retrospective study on 120 renal transplant patients aged ≥ 60 years old who received a kidney with at least a minimum time of 1 year after transplant between 2008 and 2011 in Iran. Hyperuricemia was defined if serum uric acid was ≥ 416.36 μmol/L in men (7.0 mg/dL), and ≥ 356.88 μmol/L in women (6 mg/dL) that persisted for at least 2 consecutive tests. Moderate-to-severe hyperuricemia also was defined as a serum uric acid of ≥ 475.84 μmol/L (8.0 mg/dL) in both sexes.

RESULTS

The majority of cases were men (66%) and only 9% received their grafts from deceased donors. The rate of deceased kidney transplant was higher in normouricemic patients. The prevalence of late posttransplant hyperuricemia was 37.5% of patients (n=45). Moderate-to-severe hyperuricemia was seen in 21 patients (17.5%). Although hyperuricemia was commonly observed in women than in men (43% in women vs 32% in men; P = .02), the rate of moderate-to-severe hyperuricemia was similar among both sexes (4.5% vs 4.3%; P = .9). Hyperuricemia frequently occurred in patients receiving kidney from a female donor (50% vs 29%; P = .005). In univariate analysis, a significant correlation was seen between serum uric acid and serum creatinine (r=0.5, P = .000). On multivariate regression, high serum creatinine was only a risk factor for posttransplant hyperuricemia in elderly kidney transplants (P = .000).

CONCLUSIONS

Posttransplant hyperuricemia was a quite common among elderly aged kidney recipients. It was correlated with renal allograft impairment.

摘要

目的

迄今为止,关于老年肾移植患者移植后高尿酸血症的现有数据有限。

材料与方法

我们对2008年至2011年期间在伊朗接受肾脏移植且移植后至少1年的120例年龄≥60岁的肾移植患者进行了一项回顾性研究。如果男性血清尿酸≥416.36μmol/L(7.0mg/dL),女性血清尿酸≥356.88μmol/L(6mg/dL)且连续至少2次检测持续存在,则定义为高尿酸血症。中度至重度高尿酸血症也定义为男女血清尿酸均≥475.84μmol/L(8.0mg/dL)。

结果

大多数病例为男性(66%),只有9%的患者接受的是已故供体的移植物。正常尿酸血症患者的已故肾移植率较高。移植后晚期高尿酸血症的患病率为37.5%(n = 45)。21例患者(17.5%)出现中度至重度高尿酸血症。尽管女性比男性更常出现高尿酸血症(女性为43%,男性为32%;P = 0.02),但中度至重度高尿酸血症的发生率在两性中相似(4.5%对4.3%;P = 0.9)。接受女性供体肾脏的患者中高尿酸血症频繁发生(50%对29%;P = 0.005)。在单因素分析中,血清尿酸与血清肌酐之间存在显著相关性(r = 0.5,P = 0.000)。在多因素回归分析中,高血清肌酐仅是老年肾移植患者移植后高尿酸血症的一个危险因素(P = 0.000)。

结论

移植后高尿酸血症在老年肾移植受者中相当常见。它与同种异体肾移植功能损害相关。

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