Uric acid and allograft loss from interstitial fibrosis/tubular atrophy: post hoc analysis from the angiotensin II blockade in chronic allograft nephropathy trial.
Uric acid and allograft loss from interstitial fibrosis/tubular atrophy: post hoc analysis from the angiotensin II blockade in chronic allograft nephropathy trial.
复制标题
间质纤维化/肾小管萎缩导致的尿酸和同种异体移植物损失：慢性同种异体移植肾病试验中血管紧张素 II 阻断的事后分析。
DOI：
10.1097/01.tp.0000440952.29757.66
复制
发表时间：
2014
期刊：
影响因子：
6.2
通讯作者：
Ibrahim,HassanN
中科院分区：
文献类型：
--
作者：
Hart,Allyson;Jackson,Scott;Kasiske,BertramL;Mauer,MichaelS;Najafian,Behzad;Matas,ArthurJ;Spong,Richard;Ibrahim,HassanN
BackgroundUric acid has been linked to the progression of native kidney disease. Studies evaluating its contribution to allograft function in kidney transplant recipients, among whom hyperuricemia is common, have yielded mixed results.MethodsWe evaluated the association between baseline uric acid and the primary composite outcome of doubling of interstitium or ESRD from interstitial fibrosis and tubular atrophy (IF/TA) in the Angiotensin II Blockade for Chronic Allograft Nephropathy (ABCAN) Trial participants. Subjects underwent uric acid, iothalamte GFR, and urine albumin to creatinine (ACR) measurements annually for 5 years in addition to an allograft biopsy at baseline and 5 years.ResultsBaseline uric acid was 5.57±1.48 mg/dL; male sex, higher BMI, diuretic use, and lower GFR were associated with higher uric acid, whereas older age, less than 3 HLA matches and having a female donor were associated with lower levels. In multivariate analysis adjusting for baseline GFR, uric acid was associated with doubling of interstitium or ESRD from IF/TA (OR 1.83, 95% CI, 1.06–3.17, P= 0.03). Over time, a 1 mg/dL increase in time-varying uric acid was associated with a 2.39 mL/min lower final GFR (P< 0.001) but not with the secondary outcome of creatinine doubling, ESRD, or death.ConclusionsThese data suggest that uric acid is associated with IF/TA and thus may be a viable target for intervention.
