Abstract
Purpose: The aim of this study was to investigate the changes in and implications of preoperative and postoperative serum uric acid levels in patients with living donor nephrectomy. Materials and Methods: We studied 207 patients between 1998 and 2007 at our hospital undergoing living-donor nephrectomy for kidney transplantation. The serum uric acid level and estimated glomerular filtration rate (eGFR) were measured preoperatively and at 1 year postoperatively. We also analyzed multiple independent variables such as age, sex, blood pressure, body mass index (BMI), serum total cholesterol, hemoglobin, hematocrit, total protein, albumin, calcium, and phosphorus. Results: The mean age of the study patients was 38.3±10.8 years. The mean serum uric acid concentration at 1 year after kidney donation was higher than preoperatively (5.05±1.39 mg/dl preoperatively vs. 5.85±1.14 mg/dl postoperatively) and was significantly greater in patients with hyperuricemia (uric acid≥6.8 mg/dl) than in patients without hyperuricemia (uric acid<6.8 mg/dl): 1.63±0.75 mg/dl vs. 0.69±0.66 mg/dl, respectively. The multivariate analysis showed that preoperative serum uric acid was the primary predictive factor of postoperative serum uric acid (r=1.136, p=0.001), and preoperative GFR was an independent secondary predictive factor (r=−0.004, p=0.047). The receiver operator characteristics (ROC) curves for the preoperative serum uric acid cutoff of 5.7 mg/dl showed the highest sensitivity and specificity of 96% and 86%, respectively. Conclusions: These results suggest that preoperative serum uric acid and GFR were important predictive factors of postoperative serum uric acid after living-donor nephrectomy. Therefore, in the selection and management of kidney donors, not only patients with a low GFR but also those with high uric acid (serum uric acid≥5.7 mg/dl) require careful observation before and after living-donor nephrectomy. (Korean J Urol 2009; 50:1144-1150)
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