No abstract

Background and Aims Hyperuricemia has been associated with the development of hypertension, cardiovascular, and renal disease. However, there is no data about the effect of lowering uric acid level on hypertension, renal function, and proteinuria in renal transplant patients. We therefore conducted a prospective study to investigate the benefits of allopurinol treatment in renal transplant patients and to investigate indirectly its effect on graft survival. Method A total of 105 Renal transplant recipients(RTRs) were included in this study. Patients were randomized to receive either placebo (n=51) or 300 mg/day allopurinol (n=54). We have examined uric acide, urinary albümin/Cr ratio, eGFR, CRP and blood pressure before and 24 weeks later after treatment in both group. Results In the allopurinol group, the mean serum uric acid levels, eGFR, creatinine urinary albümin/Cr ratio significantly improved(P < 0.001). However, blood pressure, CRP not statistically significant (P > 0.05). No correlation was observed between changes in uric acide and changes in CRP, or blood pressure in the allopurinol group. No significant changes were observed in the control group (P > 0.05). Multivariable regression analysis showed that uric acide was positively correlated with UACR (r= 0,473, β = 0.021, P = 0.002) and negatively correlated with eGFR ( r= -0554 β = 0.016, P = 0.001) in RTRs. Conclusion We bring indirect evidence that hyperuricemia increases urinary albümin/Cr ratio, and decreases eGFR. Hence, management of hyperuricemia may prevent the progression of renal disease, even in patients with normal renal function, suggesting that early treatment with allopurinol should be an important part of the management of renal transplant recipients. Long-term follow-up studies are warranted to identify the benefits of uric acid management on renal function and proteinuria.