TY - JOUR
T1 - Hyperuricemia is associated with the development of the composite outcomes of new cardiovascular events and chronic allograft nephropathy
AU - Akalin, Enver
AU - Ganeshan, Sri Venkatesh
AU - Winston, Jonathan
AU - Muntner, Paul
PY - 2008/9/15
Y1 - 2008/9/15
N2 - BACKGROUND.: To investigate the prevalence and the predictors for the development of hyperuricemia at 6 months after kidney transplantation, and its association with clinical outcomes including patient and graft survival, the development of new cardiovascular events and chronic allograft nephropathy (CAN). MATERIALS AND METHODS.: Adult patients who underwent kidney transplantation at Mount Sinai Medical Center between January 1, 2001 and December 30, 2004 were included in the study. New cardiovascular events and biopsy-proven CAN were investigated. RESULTS.: Of the 307 patients, 163 patients (53%) had normal uric acid levels and 144 patients (47%) had hyperuricemia. After adjustment for age, race, and sex, receiving a cadaveric kidney, having an estimated glomerular filtration rate (eGFR) less than 50 mL/min, and taking diuretics or cyclosporine were associated with hyperuricemia at 6 months after transplantation. Over a mean 4.3 years of follow-up, 83 patients had one, or more, of the events, 4 died, 20 had graft failure, 40 had new cardiovascular events, and 41 developed CAN. Kaplan-Meier survival curves showed that these events occurred more frequently in patients with hyperuricemia (P<0.001). Among transplant recipients with an eGFR less than 50 mL/min, 45% of hyperuricemic and 21% of normouricemic patients had an event (P=0.038). For patients with an eGFR more than 50 mL/min, event rates were similar for patients with and without hyperuricemia, 25.0% vs. 19.4%, respectively. CONCLUSIONS.: These results suggest an important association between hyperuricemia at 6 months after kidney transplantation and new cardiovascular events and CAN in patients with decreased allograft function.
AB - BACKGROUND.: To investigate the prevalence and the predictors for the development of hyperuricemia at 6 months after kidney transplantation, and its association with clinical outcomes including patient and graft survival, the development of new cardiovascular events and chronic allograft nephropathy (CAN). MATERIALS AND METHODS.: Adult patients who underwent kidney transplantation at Mount Sinai Medical Center between January 1, 2001 and December 30, 2004 were included in the study. New cardiovascular events and biopsy-proven CAN were investigated. RESULTS.: Of the 307 patients, 163 patients (53%) had normal uric acid levels and 144 patients (47%) had hyperuricemia. After adjustment for age, race, and sex, receiving a cadaveric kidney, having an estimated glomerular filtration rate (eGFR) less than 50 mL/min, and taking diuretics or cyclosporine were associated with hyperuricemia at 6 months after transplantation. Over a mean 4.3 years of follow-up, 83 patients had one, or more, of the events, 4 died, 20 had graft failure, 40 had new cardiovascular events, and 41 developed CAN. Kaplan-Meier survival curves showed that these events occurred more frequently in patients with hyperuricemia (P<0.001). Among transplant recipients with an eGFR less than 50 mL/min, 45% of hyperuricemic and 21% of normouricemic patients had an event (P=0.038). For patients with an eGFR more than 50 mL/min, event rates were similar for patients with and without hyperuricemia, 25.0% vs. 19.4%, respectively. CONCLUSIONS.: These results suggest an important association between hyperuricemia at 6 months after kidney transplantation and new cardiovascular events and CAN in patients with decreased allograft function.
KW - Cardiovascular disease
KW - Chronic allograft nephropathy
KW - Hyperuricemia
KW - Kidney transplantation
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U2 - 10.1097/TP.0b013e3181814f5b
DO - 10.1097/TP.0b013e3181814f5b
M3 - Article
C2 - 18791445
AN - SCOPUS:53449101073
SN - 0041-1337
VL - 86
SP - 652
EP - 658
JO - Transplantation
JF - Transplantation
IS - 5
ER -