Serum Uric Acid and Renal Transplantation Outcomes: At Least 3-Year Post-transplant Retrospective Multivariate Analysis

• Published in: PloS one Vol. 10; no. 7; p. e0133834
• Main Authors: Zhang, Kun, Gao, Baoshan, Wang, Yuantao, Wang, Gang, Wang, Weigang, Zhu, Yaxiang, Yao, Liyu, Gu, Yiming, Chen, Mo, Zhou, Honglan, Fu, Yaowen
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24-07-2015; Public Library of Science (PLoS)
• Subjects: Acids; Adult; Blood & organ donations; Body mass; Body mass index; Body size; Comorbidity; Diabetes mellitus; Diuretics; Epidermal growth factor receptors; Female; Follow-Up Studies; Glomerular Filtration Rate; Graft rejection; Grafting; Grafts; Hazards; Health aspects; Health risk assessment; Hospitals; Humans; Hypertension; Hyperuricemia; Kaplan-Meier Estimate; Kidney diseases; Kidney transplantation; Kidney Transplantation - mortality; Levels; Male; Males; Medical prognosis; Middle Aged; Mortality; Multivariate analysis; Nephrology; Prognosis; Regression analysis; Regression models; Retrospective Studies; Risk Factors; Rodents; Survival; Systematic review; Time Factors; Tissue Donors; Transplantation; Transplants & implants; Treatment Outcome; Uric acid; Uric Acid - blood; Urology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0133834

Since the association of serum uric acid and kidney transplant graft outcome remains disputable, we sought to evaluate the predictive value of uric acid level for graft survival/function and the factors could affect uric acid as time varies. A consecutive cohort of five hundred and seventy three recipients transplanted during January 2008 to December 2011 were recruited. Data and laboratory values of our interest were collected at 1, 3, 6, 12, 24 and 36 months post-transplant for analysis. Cox proportional hazard model, and multiple regression equation were built to adjust for the possible confounding variables and meet our goals as appropriate. The current cohort study lasts for 41.86 ± 15.49 months. Uric acid level is proven to be negatively associated with eGFR at different time point after adjustment for age, body mass index and male gender (standardized β ranges from -0.15 to -0.30 with all P<0.001).Males with low eGFR but high level of TG were on CSA, diuretics and RAS inhibitors and experienced at least one episode of acute rejection and diabetic issue were associated with a higher mean uric acid level. Hyperuricemia was significantly an independent predictor of pure graft failure (hazard ratio=4.01, 95% CI: 1.25-12.91, P=0.02) after adjustment. But it was no longer an independent risk factor for graft loss after adjustment. Interestingly, higher triglyceride level can make incidence of graft loss (hazard ratio=1.442, for each unit increase millimoles per liter 95% CI: 1.008-2.061, P=0.045) and death (hazard ratio=1.717, 95% CI: 1.105-2.665, P=0.016) more likely. The results of our study suggest that post-transplant elevated serum uric acid level is an independent predictor of long-term graft survival and graft function. Together with the high TG level impact on poor outcomes, further investigations for therapeutic effect are needed.