Changes and Implications of Serum Uric Acid Levels After Living-Donor Nephrectomy

Abstract

Purpose:The aim of this study was to investigate the changes in and implications of preoperative and postoperative serum uric acid levels in patients with living donor nephrectomy. Materials and Methods:We studied 207 patients between 1998 and 2007 at our hospital undergoing living-donor nephrectomy for kidney transplantation. The serum uric acid level and estimated glomerular filtration rate (eGFR) were measured preoperatively and at 1 year postoperatively. We also analyzed multiple independent variables such as age, sex, blood pressure, body mass index (BMI), serum total cholesterol, hemoglobin, hematocrit, total protein, albumin, calcium, and phosphorus. Results: The mean age of the study patients was 38.3±10.8 years. The mean serum uric acid concentration at 1 year after kidney donation was higher than preoperatively (5.05±1.39 mg/dl preoperatively vs. 5.85±1.14 mg/dl postoperatively) and was significantly greater in patients with hyperuricemia (uric acid≥6.8 mg/dl) than in patients without hyperuricemia (uric acid＜6.8 mg/dl): 1.63±0.75 mg/dl vs. 0.69±0.66 mg/dl, respectively. The multivariate analysis showed that preoperative serum uric acid was the primary predictive factor of postoperative serum uric acid (r=1.136, p=0.001), and preoperative GFR was an independent secondary predictive factor (r=−0.004, p=0.047). The receiver operator characteristics (ROC) curves for the preoperative serum uric acid cutoff of 5.7 mg/dl showed the highest sensitivity and specificity of 96% and 86%, respectively. Conclusions: These results suggest that preoperative serum uric acid and GFR were important predictive factors of postoperative serum uric acid after living-donor nephrectomy. Therefore, in the selection and management of kidney donors, not only patients with a low GFR but also those with high uric acid (serum uric acid≥5.7 mg/dl) require careful observation before and after living-donor nephrectomy. (Korean J Urol 2009; 50:1144-1150)

Cross-sectional study on the correlation of serum uric acid with disease severity in Korean patients with psoriasis

“…We then compared the clinical features of psoriasis between the normouricaemic group and the hyperuricaemic group (Table 4). We regarded the upper end of normal range as 6.0 mg/dL for women and 6.8 mg/dL for men based on recent Korean reports 22,23 . Based on this, 38 (19.2%) of the 198 patients were included in the hyperuricaemic group.…”

“…We regarded the upper end of normal range as 6.0 mg ⁄ dL for women and 6.8 mg ⁄ dL for men based on recent Korean reports. 22,23 Based on this, 38 (19.2%) of the 198 patients were included in the hyperuricaemic group. Consistent with previous findings, the PASI of the hyperuricaemic group was significantly higher (P < 0.05) than that of the normouricaemic group.…”

Metabolic risks in living kidney donors in South Korea

“…Serum uric acid concentrations are not specifically mentioned in the guidelines for living kidney donors. However, higher uric acid levels are associated with the progression of renal deterioration [ 25 ], and predonation serum uric acid levels could be an important indicator of the postoperative renal function for donors [ 26 , 27 ]. Additionally, prenephrectomy uric acid levels are a potential predictor for new-onset DM after kidney transplantation in living donors [ 28 ].…”

The current therapeutic approach for anaemia after kidney transplant

“…This results in anaemia in the pretransplant period and affects Hgb level in the immediate posttransplant period. After transplantation, as the allograft starts to regain its function, the production of EPO increases as soon as within the first 72 h [12,[14][15][16][17]. EPO production correlates with allograft function.…”