Predictors of Hyperuricemia after Kidney Transplantation: Association with Graft Function

Medicina (Kaunas). 2020 Feb 25;56(3):95. doi: 10.3390/medicina56030095.

Abstract

Background: 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.

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.

Keywords: glomerular filtration rate; hyperuricemia; kidney transplantation; uric acid.

MeSH terms

  • Adult
  • Calcineurin Inhibitors / therapeutic use
  • Diuretics / adverse effects
  • Female
  • Glomerular Filtration Rate
  • Graft Survival
  • Humans
  • Hyperuricemia / etiology*
  • Kidney / physiopathology
  • Kidney Diseases, Cystic / complications
  • Kidney Transplantation / adverse effects*
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Transplants / physiopathology
  • Uric Acid / blood
  • Xanthine Oxidase / antagonists & inhibitors

Substances

  • Calcineurin Inhibitors
  • Diuretics
  • Uric Acid
  • Xanthine Oxidase