Influence of hyperglycemia and hyperuricemia on long‐term transplant survival in kidney transplant recipients

Gerhardt, Ulf; Hüttmann, M Grosse; Hohage, Helge

doi:10.1034/j.1399-0012.1999.130502.x

Cited by 68 publications

(47 citation statements)

References 21 publications

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“…Akgül and associates 4 reported that high UA levels do not have a role on developing chronic allograft nephropathy during the first 3 years after transplant. Gerhardt and associates 12 reported significantly reduced transplant survival rates among hyperuricemic patients compared with those who were normouricemic kidney transplant recipients. In 1 study, male sex, higher body mass index, longer term pretransplant dialysis, and hypertension were associated with the development of hyperuricemia.…”

Section: Discussionmentioning

confidence: 99%

Hyperuricemia in Pediatric Renal Transplant Recipients

Gökçeoğlu

Akman²,

Koyun³

et al. 2013

Exp Clin Transplant

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Objectives: We sought to evaluate the prevalence and confounding clinical variables of hyperuricemia in pediatric kidney transplant patients. Materials and Methods:We retrospectively evaluated the medical records of 151 pediatric renal transplant recipients who received their grafts at Akdeniz University Medical Faculty in Antalya, Turkey, with a follow-up longer than 6 months. This retrospective, single-center study included 117 pediatric renal transplant recipients, after we had excluded the patients with changes in immunosuppressive treatment and graft loss, who were receiving therapy with allopurinol and furosemide. Patient information and laboratory data were obtained from patient charts and an electronic hospital database. Results: Mean uric acid levels of patients were 311 ± 74 μmol/L, and 24 of all of the patients (20%) had high uric acid levels. Fifteen patients taking tacrolimus (16%), and 9 of patients taking cyclosporine (39%) had hyperuricemia. The hyperuricemia rate of patients taking cyclosporine was significantly higher than it was for those patients taking tacrolimus (P = .014). Mean levels of uric acid in patients taking cyclosporine were higher than those of patients taking tacrolimus (344 ± 62 µmol/L and 303 ± 75 μmol/L; P = .006). There was a significant positive correlation between mean uric acid concentrations, and both serum creatinine (P = .000; r=0.487) and cystatin C (P = .000; r=0.433). There was negative correlation between mean uric acid concentration and estimated glomerular filtration rate (P = .000; r=-0.417). Mean uric acid levels of patients with intact graft function (estimated glomerular filtration rate ≥ 60 mL/min/1.73 m 2 ) was lower than the patients with a low estimated glomerular filtration rate (291 ± 67 μmol/L and 353 ± 71 μmol/L; P = .000). Mean uric acid level of patients with normal body mass index was significantly lower than that of patients who were obese-overweight (301 ± 64 μmol/L vs 343 ± 94 μmol/L; P = .045). Conclusions: We found 20% of our patient group had high uric acid levels. We also found that lower glomerular filtration rate, higher serum creatinine, cystatin c, obesity, and being overweight were risk factors for hyperuricemia in pediatric renal transplant recipients.

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Section: Discussionmentioning

confidence: 99%

Hyperuricemia in Pediatric Renal Transplant Recipients

Gökçeoğlu

Akman²,

Koyun³

et al. 2013

Exp Clin Transplant

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“…Some studies indicate that HUA is only a marker of graft dysfunction, [136][137][138][139] whereas some other studies suggest that UA is an independent risk factor for graft dysfunction. [140][141][142][143][144][145][146] Recently, Hart et al 147 reported that HUA correlated with tubular atrophy and interstitial fibrosis in chronic allograft nephropathy. Similar to the experimental findings, HUA in humans may exacerbate CsA nephrotoxicity.…”

Section: Hua and Renal Transplantationmentioning

confidence: 99%

Hyperuricemia and chronic kidney disease: an enigma yet to be solved

et al. 2014

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The role of uric acid (UA) on the pathogenesis and progression of chronic kidney disease (CKD) remains controversial. Experimental and clinical studies indicate that UA is associated with several risk factors of CKD including diabetes, hypertension, oxidative stress, and inflammation and hyperuricemia could be considered as a common dominator linking CKD and cardiovascular disease. Notably, the impact of serum UA levels on the survival of CKD, dialysis patients, and renal transplant recipients is also a matter of debate, as there are conflicting results from clinical studies. At present, there is no definite data whether UA is causal, compensatory, coincidental or it is only an epiphenomenon in these patients. In this article, we attempt to review and elucidate the dark side of this old molecule in CKD and renal transplantation.

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“…However our study shows a clear relationship between hyperuricemia and derangements in the lipid profile. Progression of the cardiovascular disease with high uric acid levels has also been postulated by many researchers 43,44 .…”

Section: Discussionmentioning

confidence: 85%

“…There are also several studies that shows that increase uric acid is a major risk factor for cardiovascular disease, kidney disease, pregnancy related complications and concomitant mortality 47,48 . Gerhardt et al found out that hyperuricemic patients have lower 5 year survival rate than normouricemic patients 49 .…”

Section: Discussionmentioning

confidence: 99%

“…Antigen independent mechanisms include interaction with cyclosporine [14][15][16][17][18] , stimulation of smooth muscle cell and association with hypertension, insulin resistance and dyslipidemia [19][20][21][22][23] Hyperuricemia occurs early after transplantation and is associated with decreased GFR. Recent studies investigating the association between increased uric acid and graft dysfunction have suggested that hyperuricemia may contribute to the progressive deterioration of graft function and ultimately to the graft loss 2,24,25 .Cyclosporine and to some extent tacrolimus used in transplant recipients causes renal vasoconstriction, hypertension and hyperuricemia.…”

Section: Introductionmentioning

confidence: 99%

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