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Early onset hyperuricemia is a prognostic marker for kidney graft failure: Propensity score matching analysis in a Korean multicenter cohort

It remains inconclusive whether hyperuricemia is a true risk factor for kidney graft failure. In the current study, we investigated the association of hyperuricemia and graft outcome. We performed a multi-center cohort study that included 2620 kidney transplant recipients. The patients were classifi...

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Autores principales: Han, Miyeun, Lee, Jung Pyo, Park, Seokwoo, Kim, Yunmi, Kim, Yong Chul, Ahn, Curie, Han, Duck Jong, Ha, Jongwon, Jung, In Mok, Lim, Chun Soo, Kim, Yon Su, Kim, Young Hoon, Oh, Yun Kyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5415138/
https://www.ncbi.nlm.nih.gov/pubmed/28467476
http://dx.doi.org/10.1371/journal.pone.0176786
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author Han, Miyeun
Lee, Jung Pyo
Park, Seokwoo
Kim, Yunmi
Kim, Yong Chul
Ahn, Curie
Han, Duck Jong
Ha, Jongwon
Jung, In Mok
Lim, Chun Soo
Kim, Yon Su
Kim, Young Hoon
Oh, Yun Kyu
author_facet Han, Miyeun
Lee, Jung Pyo
Park, Seokwoo
Kim, Yunmi
Kim, Yong Chul
Ahn, Curie
Han, Duck Jong
Ha, Jongwon
Jung, In Mok
Lim, Chun Soo
Kim, Yon Su
Kim, Young Hoon
Oh, Yun Kyu
author_sort Han, Miyeun
collection PubMed
description It remains inconclusive whether hyperuricemia is a true risk factor for kidney graft failure. In the current study, we investigated the association of hyperuricemia and graft outcome. We performed a multi-center cohort study that included 2620 kidney transplant recipients. The patients were classified as either normouricemic or hyperuricemic at 3 months after transplantation. Hyperuricemia was defined as a serum uric acid level ≥ 7.0 mg/dL in males or ≥ 6.0 mg/dL in females or based on the use of urate-lowering medications. The two groups were compared before and after propensity score matching. A total of 657 (25.1%) patients were classified as hyperuricemic. The proportion of hyperuricemic patients increased over time, reaching 44.2% of the total cohort at 5 years after transplantation. Estimated glomerular filtration rate and donor type were independently associated with hyperuricemia. Hyperuricemia was associated with graft loss according to multiple Cox regression analysis before propensity score matching (hazard ratio [HR] = 1.56, 95% confidence interval [CI] = 1.14–2.13, P = 0.005) as well as after matching (HR = 1.65, 95% CI = 1.13–2.42, p = 0.010). Cox regression models using time-varying hyperuricemia or marginal structural models adjusted with time-varying eGFR also demonstrated significant hazards of hyperuricemia for graft loss. Cardiovascular events and recipient survival were not associated with hyperuricemia. Overall, hyperuricemia, especially early onset after transplantation, showed an increased risk for graft failure. Further studies are warranted to determine whether lowering serum uric acid levels would be beneficial to graft survival.
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spelling pubmed-54151382017-05-14 Early onset hyperuricemia is a prognostic marker for kidney graft failure: Propensity score matching analysis in a Korean multicenter cohort Han, Miyeun Lee, Jung Pyo Park, Seokwoo Kim, Yunmi Kim, Yong Chul Ahn, Curie Han, Duck Jong Ha, Jongwon Jung, In Mok Lim, Chun Soo Kim, Yon Su Kim, Young Hoon Oh, Yun Kyu PLoS One Research Article It remains inconclusive whether hyperuricemia is a true risk factor for kidney graft failure. In the current study, we investigated the association of hyperuricemia and graft outcome. We performed a multi-center cohort study that included 2620 kidney transplant recipients. The patients were classified as either normouricemic or hyperuricemic at 3 months after transplantation. Hyperuricemia was defined as a serum uric acid level ≥ 7.0 mg/dL in males or ≥ 6.0 mg/dL in females or based on the use of urate-lowering medications. The two groups were compared before and after propensity score matching. A total of 657 (25.1%) patients were classified as hyperuricemic. The proportion of hyperuricemic patients increased over time, reaching 44.2% of the total cohort at 5 years after transplantation. Estimated glomerular filtration rate and donor type were independently associated with hyperuricemia. Hyperuricemia was associated with graft loss according to multiple Cox regression analysis before propensity score matching (hazard ratio [HR] = 1.56, 95% confidence interval [CI] = 1.14–2.13, P = 0.005) as well as after matching (HR = 1.65, 95% CI = 1.13–2.42, p = 0.010). Cox regression models using time-varying hyperuricemia or marginal structural models adjusted with time-varying eGFR also demonstrated significant hazards of hyperuricemia for graft loss. Cardiovascular events and recipient survival were not associated with hyperuricemia. Overall, hyperuricemia, especially early onset after transplantation, showed an increased risk for graft failure. Further studies are warranted to determine whether lowering serum uric acid levels would be beneficial to graft survival. Public Library of Science 2017-05-03 /pmc/articles/PMC5415138/ /pubmed/28467476 http://dx.doi.org/10.1371/journal.pone.0176786 Text en © 2017 Han et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Han, Miyeun
Lee, Jung Pyo
Park, Seokwoo
Kim, Yunmi
Kim, Yong Chul
Ahn, Curie
Han, Duck Jong
Ha, Jongwon
Jung, In Mok
Lim, Chun Soo
Kim, Yon Su
Kim, Young Hoon
Oh, Yun Kyu
Early onset hyperuricemia is a prognostic marker for kidney graft failure: Propensity score matching analysis in a Korean multicenter cohort
title Early onset hyperuricemia is a prognostic marker for kidney graft failure: Propensity score matching analysis in a Korean multicenter cohort
title_full Early onset hyperuricemia is a prognostic marker for kidney graft failure: Propensity score matching analysis in a Korean multicenter cohort
title_fullStr Early onset hyperuricemia is a prognostic marker for kidney graft failure: Propensity score matching analysis in a Korean multicenter cohort
title_full_unstemmed Early onset hyperuricemia is a prognostic marker for kidney graft failure: Propensity score matching analysis in a Korean multicenter cohort
title_short Early onset hyperuricemia is a prognostic marker for kidney graft failure: Propensity score matching analysis in a Korean multicenter cohort
title_sort early onset hyperuricemia is a prognostic marker for kidney graft failure: propensity score matching analysis in a korean multicenter cohort
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5415138/
https://www.ncbi.nlm.nih.gov/pubmed/28467476
http://dx.doi.org/10.1371/journal.pone.0176786
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