Risk Factors of Hyperuricemia After Renal Transplantation and Its Long-term Effects on Graft Functions

Eyupoglu, Sahin; Eyupoglu, Damla; Celebi, Zeynep Kendi; Aktürk, Serkan; Tüzüner, Acar; Keven, Kenan; Şengül, Şule

doi:10.1016/j.transproceed.2017.01.006

Cited by 7 publications

(8 citation statements)

References 21 publications

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“…Moreover, diuretics reduce uric acid excretion, presumably by causing mild volume depletion with enhancement of proximal tubular reabsorption [31]. Similarly, the association between diuretic use and HU in KTR has been reported by Bandukwal et al [32] and Eyupoglu et al [33]. This is of practical importance, as the of elevated blood pressure of KTR has been reported to be as high as 85% [34], but diuretics have remained the cornerstone of antihypertensive treatment since their introduction in the 1960s.…”

Section: Discussionmentioning

confidence: 81%

Predictors of Hyperuricemia after Kidney Transplantation: Association with Graft Function

et al. 2020

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Background and objectives: In kidney transplant recipients (KTR), hyperuricemia (HU) is a commonly-observed phenomenon, due to calcineurin inhibitors and reduced kidney graft function. Factors predicting HU, and its association with graft function, remains equivocal. Materials and Methods: We conducted a retrospective longitudinal study to assess factors associated with HU in KTR, and to determine risk factors associated with graft function, measured as glomerular filtration rate (GFR). Moreover, GFR > 60 mL/min/1.73 m2 was considered normal. HU was defined as a serum uric acid level of > 416 μmol/L (4.70 mg/dL) in men and >357 μmol/L (4.04 mg/dL) in women, or xanthine-oxidase inhibitor use. We built multiple logistic regression models to assess predictors of HU in KTR, as well as the association of demographic, clinical, and biochemical parameters of patients with normal GFR after a three-year follow-up. We investigated the effect modification of this association with HU. Results: There were 144 patients (mean age 46.6 ± 13.9), with 42.4% of them having HU. Predictors of HU in KTR were the presence of cystic diseases (OR = 9.68 (3.13; 29.9)), the use of diuretics (OR = 4.23 (1.51; 11.9)), and the male gender (OR = 2.45 (1.07; 5.56)). Being a younger age, of female gender, with a normal BMI, and the absence of diuretic medications increased the possibility of normal GFR. HU was the effect modifier of the association between demographic, clinical, and biochemical factors and a normal GFR. Conclusions: Factors associated with HU in KTR: Presence of cystic diseases, diuretic use, and male gender. HU was the effect modifier of the association of demographic, clinical, and biochemical factors to GFR.

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Section: Discussionmentioning

confidence: 81%

Predictors of Hyperuricemia after Kidney Transplantation: Association with Graft Function

et al. 2020

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“…The risk of developing hypertension is greater in subjects with hyperuricemia and the risk augments with age. Increased serum uric acid is significantly associated with the development of new-onset primary hypertension in children [34]. In a large meta-analysis of 25 studies including 97,824 participants, the elevated uric acid level predicted systemic hypertension [27].…”

Section: Hyperuricemia Ckd and Existing Comorbiditiesmentioning

confidence: 99%

“…Hyperuricemia is common in renal transplant recipients [33]. Following transplantation, lower eGFR levels have been correlated with higher levels of serum uric acid [34]. Moreover, hyperuricemia is an adverse effect of calcineurin inhibitors, mainly ciclosporin.…”

Section: Hyperuricemia Ckd and Existing Comorbiditiesmentioning

confidence: 99%

“…However, the impact of eGFR on graft survival and mortality remains a subject of debate. Studies have reported that hyperuricemia is not associated with loss of graft or increased rates of mortality [34]. In a retrospective cohort analysis in almost 3000 kidney transplant patients, Kim et al found that normal to low levels of serum uric acid during the first-year post-transplantation and over a 5-year follow-up period were associated with better allograft outcomes [35].…”

Section: Hyperuricemia Ckd and Existing Comorbiditiesmentioning

confidence: 99%

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Management of Hyperuricemia in Patients with Chronic Kidney Disease: a Focus on Renal Protection

2020

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Purpose of Review In chronic kidney disease (CKD), plasma uric acid levels are increased because of the decrease in glomerular filtration rate. However, in addition to CKD, hyperuricemia is frequently associated with a number of other conditions such as hypertension, type 2 diabetes, obesity, and heart failure, overweight, and cardiovascular disease. Recent Findings It is now becoming increasingly clear that, in many clinical conditions, elevated levels of uric acid have a much greater role beyond just causing gout. The present review will summarize current knowledge on the relation between hyperuricemia, CKD, and existing comorbidities, as well as the mechanisms of uric acid–related renal damage. In addition, the role and evidence for urate-lowering therapy in prevention and cardiovascular protection in CKD patients is discussed with a focus on allopurinol and febuxostat. To date, several clinical studies have provided evidence that urate-lowering therapy may help to prevent and delay the decline of renal function in patients with CKD. Summary Use of a xanthine oxidase inhibitor should be considered in patients who are at high renal risk and/or with declining renal function in the presence of hyperuricemia with and without deposition, although additional studies are warranted to define treatment targets. Notwithstanding, the possibility to delay deterioration of renal function in patients with CKD merits consideration.

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“…Hyperuricemia and gout are common problems in patients with chronic kidney disease and are also a common complication in kidney transplant recipients . Approximately 15% of hyperuricemia cases and 20% of gout cases occur in adult patients with chronic kidney disease stage ≥3 .…”

Section: Introductionmentioning

confidence: 99%

Risk of incident gout in kidney transplant recipients: A retrospective cohort study

et al. 2018

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Aim: Gout is a common complication in kidney transplant recipients. This study evaluated the association between kidney transplant recipients and the long-term risk of incident gout. Method: For this age-matched and sex-matched retrospective cohort study, the Catastrophic Illness Certificate Database and the National Health Insurance Research Database were combined between 1997 and 2010. The study included 5917 patients with kidney transplants and 23 668 matched kidney transplant-free subjects. Hazard ratio (HR) for risk of incident gout was calculated using the Cox proportional hazards regression.Results: In this study, of the 5917 kidney transplant recipients, 521 (8.8%) had gout. The kidney transplant group had a higher risk of incident gout than those in the matched kidney transplant-free group (adjusted HR = 1.55, 95% confidence intervals [CI] = 1.36-1.77), particularly within 3 years following kidney transplant recipients (adjusted HR = 2.61, 95% CI = 2.13-3.20). We observed that at the >3 to 6 years and the >6 to 9 years follow-up, patients with kidney transplant did not have a significant association with risk of incident gout (adjusted HR = 0.92, P = 0.4806 and adjusted HR = 1.26, P = 0.1901, respectively). Conclusion:These findings revealed that risk of incident gout increased within 3 years following kidney transplant recipients and the individual's long-term risk of incident gout between kidney transplant recipients and the general population remained similar.Yi-Ching Tung and Hung-Pin Tu contributed equally to this work.

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Risk Factors of Hyperuricemia After Renal Transplantation and Its Long-term Effects on Graft Functions

Cited by 7 publications

References 21 publications

Predictors of Hyperuricemia after Kidney Transplantation: Association with Graft Function

Predictors of Hyperuricemia after Kidney Transplantation: Association with Graft Function

Management of Hyperuricemia in Patients with Chronic Kidney Disease: a Focus on Renal Protection

Risk of incident gout in kidney transplant recipients: A retrospective cohort study

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