Department of Surgery, Japanese Red Cross Kumamoto Hospital, 861-8520, 2-1-1 Nagamine Minami, Higashi-ku, Kumamoto, Japan.
Department of Nephrology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
BMC Nephrol. 2021 Mar 12;22(1):89. doi: 10.1186/s12882-021-02295-0.
Preoperative characteristics of living kidney donors are commonly considered during donor selection and postoperative follow-up. However, the impact of preoperative uric acid (UA) levels is poorly documented. The aim of this study was to evaluate the association between preoperative serum UA levels and post-donation long-term events and renal function.
This was a single-center retrospective analysis of 183 living kidney donors. The donors were divided into high (≥5.5 mg/dl) and low (< 5.5 mg/dl) UA groups. We analyzed the relationship between preoperative UA levels and postoperative estimated glomerular filtration rate (eGFR), as well as adverse events (cardiovascular events and additional prescriptions for hypertension, gout, dyslipidemia, and diabetes mellitus), over 5 years after donation.
In total, 44 donors experienced 52 adverse events over 5 years. The incidence of adverse events within 5 years was significantly higher in the high UA group than in the low UA group (50% vs. 24%, p = 0.003); this was true even after the exclusion of hyperuricemia-related events (p = 0.047). UA emerged as an independent risk factor for adverse events (p = 0.012). Donors with higher UA levels had lower eGFRs after donation, whereas body mass index, hemoglobin A1c, blood pressure, and low-density lipoprotein cholesterol did not have any impact on the eGFR.
The findings suggest that preoperative UA levels should be considered during donor selection and postoperative follow-up.
在进行供者选择和术后随访时,通常会考虑活体肾捐献者的术前特征。然而,术前尿酸(UA)水平的影响尚未得到充分证实。本研究旨在评估术前血清 UA 水平与捐肾后长期事件和肾功能之间的关系。
这是一项对 183 名活体肾捐献者的单中心回顾性分析。将捐献者分为高(≥5.5mg/dl)和低(<5.5mg/dl)UA 组。我们分析了术前 UA 水平与捐肾后 5 年内估算肾小球滤过率(eGFR)以及不良事件(心血管事件和高血压、痛风、血脂异常和糖尿病的额外处方)之间的关系。
共有 44 名捐献者在 5 年内发生了 52 次不良事件。高 UA 组的不良事件发生率在 5 年内明显高于低 UA 组(50%比 24%,p=0.003);即使排除了与高尿酸血症相关的事件后也是如此(p=0.047)。UA 是不良事件的独立危险因素(p=0.012)。UA 水平较高的捐献者在捐肾后 eGFR 较低,而体重指数、糖化血红蛋白、血压和低密度脂蛋白胆固醇对 eGFR 没有影响。
研究结果表明,在进行供者选择和术后随访时,应考虑术前 UA 水平。