Hyperuricemia is associated with the development of the composite outcomes of new cardiovascular events and chronic allograft nephropathy

Enver Akalin, Sri Venkatesh Ganeshan, Jonathan Winston, Paul Muntner

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53 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)652-658
Number of pages7
JournalTransplantation
Volume86
Issue number5
DOIs
StatePublished - Sep 15 2008
Externally publishedYes

Fingerprint

Hyperuricemia
Allografts
Glomerular Filtration Rate
Kidney Transplantation
Kaplan-Meier Estimate
Graft Survival
Uric Acid
Diuretics
Cyclosporine
Transplantation

Keywords

  • Cardiovascular disease
  • Chronic allograft nephropathy
  • Hyperuricemia
  • Kidney transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Hyperuricemia is associated with the development of the composite outcomes of new cardiovascular events and chronic allograft nephropathy. / Akalin, Enver; Ganeshan, Sri Venkatesh; Winston, Jonathan; Muntner, Paul.

In: Transplantation, Vol. 86, No. 5, 15.09.2008, p. 652-658.

Research output: Contribution to journalArticle

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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.

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