Investigating Serum Uric Acid as a Risk Factor in the Development of Delayed Renal Recovery in Living Kidney Donors

Transplant Proc. 2017 Jun;49(5):930-934. doi: 10.1016/j.transproceed.2017.03.034.

Abstract

Background: Hyperuricemia has been associated with kidney disease and remains controversial with regard to its gender-specific differences and impact in living kidney donation.

Methods: Between 2006 and 2015, charts of live kidney donors who underwent nephrectomy and had a minimum follow-up of 1 year were reviewed. A total of 291 donors were included and divided based on gender-specific pre-donation serum uric acid (SUA) tertiles. Renal functional outcomes included were estimated glomerular filtration rate (eGFR) at 6-month and 1-year follow-up and percentage of donors with a 1-year eGFR <60 mL/min/1.72 m2. Logistic regression analysis was done.

Results: Mean SUA tertiles were 5.8 ± 1.1 mg/dL in males and 4.1 ± 1 mg/dL in females. Females in the highest tertile (SUA >4.5 mg/dL) had lower 6-month (59.9 ± 10.3 vs 66.9 ± 14.1 vs 67.3 ± 12.1; P = .018) and 1-year (60.8 ± 10.6 vs 67.6 ± 10.8 vs 67.8 ± 11.8; P = .021) eGFR and a higher percentage of donors with 1-year eGFR <60 mL/min/1.73 m2 (59.5% vs 31.6% vs 23%; P = .002) compared with donors in the lower SUA tertiles (≤4.5 mg/dL). In males, there were similar eGFRs among SUA tertiles at 6-month and 1-year follow-up. In multivariate analysis, SUA was shown to be a significant predictor of developing stage 3 CKD (eGFR <60 mL/min/1.72 m2), 1 year after donation in females but not in males.

Conclusions: Predonation SUA level is associated with the development of delayed renal recovery (GFR <60 mL/min/1.72 m2) 1 year after donation in females but not in males.

MeSH terms

  • Female
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Hyperuricemia / etiology*
  • Kidney / physiopathology*
  • Kidney Transplantation
  • Living Donors*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nephrectomy / adverse effects*
  • Risk Factors
  • Tissue and Organ Procurement
  • Uric Acid / blood

Substances

  • Uric Acid