Einollahi Behzad, Einollahi Hoda, Rostami Zohreh
Department of Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Exp Clin Transplant. 2011 Dec;9(6):376-80.
To date, limited data are currently available on posttransplant hyperuricemia in elderly renal transplant patients.
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.
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).
Posttransplant hyperuricemia was a quite common among elderly aged kidney recipients. It was correlated with renal allograft impairment.
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。
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)。
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)。
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。