Eyupoglu S, Eyupoglu D, Kendi-Celebi Z, Akturk S, Tuzuner A, Keven K, Sengul S
Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey.
Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
Transplant Proc. 2017 Apr;49(3):505-508. doi: 10.1016/j.transproceed.2017.01.006.
Hyperuricemia is a common complication in renal transplant recipients. Recent studies have suggested that hyperuricemia may contribute to the deterioration of graft function.
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).
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).
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.
高尿酸血症是肾移植受者常见的并发症。近期研究表明，高尿酸血症可能导致移植肾功能恶化。
在本研究中，我们旨在调查与高尿酸血症相关的危险因素以及高尿酸血症对移植功能障碍、移植肾存活、心血管事件和死亡率的影响。在2005年至2016年期间，141例至少随访5年的肾移植患者纳入了这项回顾性队列研究。采用多元线性回归分析来确定平均血清尿酸水平与估计肾小球滤过率（eGFR）之间的关系。
平均移植年龄为37.1±12.1岁，平均随访时间为83.09±20.30个月；高尿酸血症患者的患病率为39例（27.6%）。在血脂异常（P = 0.026）、使用β受体阻滞剂（P = 0.002）和噻嗪类利尿剂（P = 0.020）的情况下，女性的平均尿酸水平更高（P < 0.001）。高尿酸血症患者（P < 0.001）、新发高血压患者（P = 0.027）、使用β受体阻滞剂患者（P = 0.005）和使用噻嗪类利尿剂患者（P = 0.040）的eGFR水平与其他受者相比有统计学差异。多变量回归分析表明，移植后的eGFR水平与平均尿酸水平（β = -0.46，P = 0.001）、供体年龄（β = -0.18，P = 0.048）、受者年龄（β = -0.28，P = 0.0003）和平均血红蛋白水平（β = 0.31，P = 0.003）相关。
尿酸正常组和高尿酸血症组之间移植肾丢失、总体死亡率和心血管事件方面无差异。尿酸水平升高会导致肾移植患者的eGFR下降。另一方面，尿酸水平对移植肾存活、心血管事件和总体死亡率的影响仍存在争议。
