Hyperuricemia is associated with the development of the composite outcomes of new cardiovascular events and chronic allograft nephropathy

Transplantation. 2008 Sep 15;86(5):652-8. doi: 10.1097/TP.0b013e3181814f5b.


Background: To investigate the prevalence and the predictors for the development of hyperuricemia at 6 months after kidney transplantation, and its association with clinical outcomes including patient and graft survival, the development of new cardiovascular events and chronic allograft nephropathy (CAN).

Materials and methods: Adult patients who underwent kidney transplantation at Mount Sinai Medical Center between January 1, 2001 and December 30, 2004 were included in the study. New cardiovascular events and biopsy-proven CAN were investigated.

Results: Of the 307 patients, 163 patients (53%) had normal uric acid levels and 144 patients (47%) had hyperuricemia. After adjustment for age, race, and sex, receiving a cadaveric kidney, having an estimated glomerular filtration rate (eGFR) less than 50 mL/min, and taking diuretics or cyclosporine were associated with hyperuricemia at 6 months after transplantation. Over a mean 4.3 years of follow-up, 83 patients had one, or more, of the events, 4 died, 20 had graft failure, 40 had new cardiovascular events, and 41 developed CAN. Kaplan-Meier survival curves showed that these events occurred more frequently in patients with hyperuricemia (P<0.001). Among transplant recipients with an eGFR less than 50 mL/min, 45% of hyperuricemic and 21% of normouricemic patients had an event (P=0.038). For patients with an eGFR more than 50 mL/min, event rates were similar for patients with and without hyperuricemia, 25.0% vs. 19.4%, respectively.

Conclusions: These results suggest an important association between hyperuricemia at 6 months after kidney transplantation and new cardiovascular events and CAN in patients with decreased allograft function.

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Female
  • Graft Survival
  • Humans
  • Hyperuricemia / epidemiology*
  • Hyperuricemia / etiology
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / pathology
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Selection
  • Postoperative Complications / blood*
  • Retrospective Studies
  • Time Factors
  • Transplantation, Homologous