Hyperuricemia at 1 Year After Renal Transplantation, Its Prevalence, Associated Factors, and Graft Survival
Hyperuricemia at 1 Year After Renal Transplantation, Its Prevalence, Associated Factors, and Graft Survival
复制标题
DOI：
10.1097/tp.0b013e318254391b
复制
发表时间：
2012-07-27
期刊：
影响因子：
6.2
通讯作者：
Habuchi, Tomonori
中科院分区：
文献类型：
--
作者：
Numakura, Kazuyuki;Satoh, Shigeru;Habuchi, Tomonori
背景本研究调查了移植后1年内高尿酸血症的患病率和预测因素，以及它们与服用他克莫司和霉酚酸酯的患者的遗传多态性和移植结局的关系。2001年1月至2009年3月期间，对121例肾移植受者进行了研究。移植后1年内血清尿酸浓度高于7.0 mg/dL的患者被定义为高尿酸血症，所有患者均接受别嘌呤醇治疗。检测一氧化氮合酶、血管紧张素转换酶、亚甲基四氢叶酸还原酶和3种尿酸转运蛋白的遗传多态性。移植后1年，46例（38%）受者发生高尿酸血症。男性、高体重指数、长期移植前透析和高血压与高尿酸血症的发生有关。移植后1年，患有高尿酸血症的患者的估计肾小球滤过率（eGFR）低于没有高尿酸血症的患者。两组移植物存活率无差异。他克莫司和霉酚酸的药代动力学和6个基因多态性与高尿酸血症无关。在多变量分析中，男性、长期移植前透析（936个月）和eGFR（G60 mL/min）与高尿酸血症的发生独立相关。高尿酸血症的发生率为38%。男性和长期移植前透析是高尿酸血症发生的预测因素。高尿酸血症患者的eGFR较低，但接受别普利诺治疗的高尿酸血症患者和无高尿酸血症患者的移植物存活率无差异。我们不能确定免疫抑制剂的药代动力学和高尿酸血症的遗传危险因素的意义。
Background. The present study investigated the prevalence and predictors for the development of hyperuricemia within 1 year after transplantation and their associations with genetic polymorphisms and graft outcome in patients taking tacrolimus and mycophenolate mofetil.Methods. One hundred twenty-one renal allograft recipients transplanted between January 2001 and March 2009 were studied. Patients with serum uric acid concentrations above 7.0 mg/dL within 1 year after transplantation were defined as having hyperuricemia, and all were treated with allopurinol. Genetic polymorphisms of nitric oxide synthase, angiotensin-converting enzyme, methylenetetrahydrofolate reductase, and 3 uric acid transporters were examined.Results. At 1 year after transplantation, 46 (38%) recipients developed hyperuricemia. Male gender, higher body mass index, long-term pretransplantation dialysis, and hypertension were associated with the development of hyperuricemia. The estimated glomerular filtration rate (eGFR) at 1 year after transplantation was lower in the patients with hyperuricemia than in those without. There were no differences in graft survival between the two groups. The pharmacokinetics of tacrolimus and mycophenolic acid and 6 polymorphisms were not associated with hyperuricemia. In the multivariate analysis, male gender, long-term pretransplantation dialysis (936 months), and eGFR (G60 mL/min) were independently associated with the development of hyperuricemia.Conclusion. The incidence of hyperuricemia in our cohort was 38%. Male gender and long-term pretransplantation dialysis were predictors for the development of hyperuricemia. The eGFR was lower in patients with hyperuricemia, but graft survival did not differ between the patients with hyperuricemia treated with alloprinol and those without hyperuricemia. We could not define the significance of the pharmacokinetics of immunosuppressants and genetic risk factors for hyperuricemia.