Abstract
Background: Hyperuricemia is frequent among renal transplant recipients. The role of the HLA system in the susceptibility of hyperuricemia is unknown. Methods: We evaluated the HLA-B and HLA-DRB1 distribution among 160 renal recipients: 132 with hyperuricemia (Group 1) and 28 free of it (Group 2) as well as 381 ethnic-specific Mexicanmestizo population historic controls. The HLA alleles were assessed by PCR-SSP and the HLA allele gene frequencies were obtained by direct gene counting and compared by X 2 test. P values were adjusted by Bonferroni. Results: The median post-transplant follow-up was 3.9 years. The prevalence of diabetes, hypertension and use of calcineurin inhibitors was similar among groups; however dyslipidemia predominated in Group 1. HLA-B*35 and B*39 alleles were more frequent in Group 2 vs. controls (OR 2.17 95% CI 1.1-4.0; p = 0.01 and OR = 2.17, CI 95% 1.07-4.34; p = 0.04, respectively). Compared to controls, Group 1 had a higher prevalence of the allele HLA-B*60 (OR 3.5 95% CI 1.52-8.3; p = 0.004). The allele HLA-DRB1*14 predominated in Group 2 when compared with Group 1(OR 3.12 95% CI 1.06-9.9, p = 0.03) and controls (OR 2.50 95% CI 1.13-5, p = 0.007). Conclusion: The HLA allele distribution differed among groups, suggesting that hyperuricemia in the renal transplant setting might be influenced by ethnicity. Prospective studies using predicting HLA models in different ethnic populations are needed.
Highlights
In the renal post-transplant setting, the presence of hyperuricemia and gout are frequent problems, with prevalence of 19-84% and 3.528%, respectively
Studies regarding the influence of genetics in gout and hyperuricemia have been primarily limited to familiar uncommon mutations or to genes related to the regulation of renal excretion of uric acid (SLC22A12, SCL2A9, ABCG2, SLC17A3, etc.) [3,4,5]
Patients were from a parent study where we studied the incidence of hyperuricemia [12]
Summary
In the renal post-transplant setting, the presence of hyperuricemia and gout are frequent problems, with prevalence of 19-84% and 3.528%, respectively. These conditions have been associated with the use of diuretics, impaired renal function and mainly with the use of cyclosporine A [1,2]. In Pakistani population, the allele DRB1*13 is more prevalent among diabetic patients [10]. Non-alcoholic fatty liver disease has been associated with the presence of HLA-B*65 in Turkish population [11]. The role of the HLA system in the susceptibility of hyperuricemia is unknown
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