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Association between post-transplant serum uric acid levels and kidney transplantation outcomes
BACKGROUND: Serum uric acid (UA) level has been reported to be associated with chronic allograft nephropathy and graft failure in patients who undergo kidney transplantation (KT). However, the role of serum UA level in renal graft survival remains controversial. OBJECTIVE: This study aimed to invest...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294369/ https://www.ncbi.nlm.nih.gov/pubmed/30550582 http://dx.doi.org/10.1371/journal.pone.0209156 |
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author | Kim, Deok Gie Choi, Hoon Young Kim, Ha Yan Lee, Eun Ju Huh, Kyu Ha Kim, Myoung Soo Nam, Chung Mo Kim, Beom Seok Kim, Yu Seun |
author_facet | Kim, Deok Gie Choi, Hoon Young Kim, Ha Yan Lee, Eun Ju Huh, Kyu Ha Kim, Myoung Soo Nam, Chung Mo Kim, Beom Seok Kim, Yu Seun |
author_sort | Kim, Deok Gie |
collection | PubMed |
description | BACKGROUND: Serum uric acid (UA) level has been reported to be associated with chronic allograft nephropathy and graft failure in patients who undergo kidney transplantation (KT). However, the role of serum UA level in renal graft survival remains controversial. OBJECTIVE: This study aimed to investigate the effect of mean serum UA level during two different post-KT periods on long-term renal graft outcomes in a large population cohort in which living donor KT prevails. MATERIAL AND METHODS: A retrospective cohort study was performed using KT data prospectively collected at a single institution. Patients (n = 2,993) were divided into low-, normal-, and high-UA groups according to the mean serum UA level within the first year (1-YR) and 1–5 years (5-YR) after transplantation. RESULTS: In the 1-YR Cox proportional hazards analysis, the low- and high-UA groups had a significantly decreased and increased risk, respectively, for overall graft failure (OGF), death-censored graft failure (DCGF), and composite event (return to dialysis, retransplantation, death from graft dysfunction, and 40% decline in estimated glomerular filtration rate) compared with the normal-UA group. Similarly, in the 5-YR analysis, the low-UA group had a significantly reduced risk of DCGF compared with the normal-UA group, whereas the high-UA group had a significantly increased risk of all three graft outcomes. In a marginal structural model, hyperuricemia had a significant causal effect on worsening graft outcomes, with consideration of all confounding variables (OGF: hazard ratio [HR] 2.27, 95% confidence interval [CI] 1.33–3.78; DCGF: HR 2.38, 95% CI 1.09–4.9; composite event: HR 3.05, 95% CI 1.64–5.49). CONCLUSIONS: A low-to-normal serum UA level within the first year and 1–5 years after KT is an independent factor for better renal allograft outcomes in the long-term follow-up period rather than high serum UA level. |
format | Online Article Text |
id | pubmed-6294369 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-62943692018-12-28 Association between post-transplant serum uric acid levels and kidney transplantation outcomes Kim, Deok Gie Choi, Hoon Young Kim, Ha Yan Lee, Eun Ju Huh, Kyu Ha Kim, Myoung Soo Nam, Chung Mo Kim, Beom Seok Kim, Yu Seun PLoS One Research Article BACKGROUND: Serum uric acid (UA) level has been reported to be associated with chronic allograft nephropathy and graft failure in patients who undergo kidney transplantation (KT). However, the role of serum UA level in renal graft survival remains controversial. OBJECTIVE: This study aimed to investigate the effect of mean serum UA level during two different post-KT periods on long-term renal graft outcomes in a large population cohort in which living donor KT prevails. MATERIAL AND METHODS: A retrospective cohort study was performed using KT data prospectively collected at a single institution. Patients (n = 2,993) were divided into low-, normal-, and high-UA groups according to the mean serum UA level within the first year (1-YR) and 1–5 years (5-YR) after transplantation. RESULTS: In the 1-YR Cox proportional hazards analysis, the low- and high-UA groups had a significantly decreased and increased risk, respectively, for overall graft failure (OGF), death-censored graft failure (DCGF), and composite event (return to dialysis, retransplantation, death from graft dysfunction, and 40% decline in estimated glomerular filtration rate) compared with the normal-UA group. Similarly, in the 5-YR analysis, the low-UA group had a significantly reduced risk of DCGF compared with the normal-UA group, whereas the high-UA group had a significantly increased risk of all three graft outcomes. In a marginal structural model, hyperuricemia had a significant causal effect on worsening graft outcomes, with consideration of all confounding variables (OGF: hazard ratio [HR] 2.27, 95% confidence interval [CI] 1.33–3.78; DCGF: HR 2.38, 95% CI 1.09–4.9; composite event: HR 3.05, 95% CI 1.64–5.49). CONCLUSIONS: A low-to-normal serum UA level within the first year and 1–5 years after KT is an independent factor for better renal allograft outcomes in the long-term follow-up period rather than high serum UA level. Public Library of Science 2018-12-14 /pmc/articles/PMC6294369/ /pubmed/30550582 http://dx.doi.org/10.1371/journal.pone.0209156 Text en © 2018 Kim 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 Kim, Deok Gie Choi, Hoon Young Kim, Ha Yan Lee, Eun Ju Huh, Kyu Ha Kim, Myoung Soo Nam, Chung Mo Kim, Beom Seok Kim, Yu Seun Association between post-transplant serum uric acid levels and kidney transplantation outcomes |
title | Association between post-transplant serum uric acid levels and kidney transplantation outcomes |
title_full | Association between post-transplant serum uric acid levels and kidney transplantation outcomes |
title_fullStr | Association between post-transplant serum uric acid levels and kidney transplantation outcomes |
title_full_unstemmed | Association between post-transplant serum uric acid levels and kidney transplantation outcomes |
title_short | Association between post-transplant serum uric acid levels and kidney transplantation outcomes |
title_sort | association between post-transplant serum uric acid levels and kidney transplantation outcomes |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294369/ https://www.ncbi.nlm.nih.gov/pubmed/30550582 http://dx.doi.org/10.1371/journal.pone.0209156 |
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