Abstract
BackgroundHigher serum uric acid (UA) levels are associated with poorer renal prognosis. In kidney transplantation, both donors and recipients are diagnosed as having chronic kidney diseases (CKD) based on renal function; however, their UA levels slightly vary. Elucidating the differences in UA would help improve kidney prognosis, especially for recipients. Therefore, we investigated UA levels in kidney transplant recipients by comparing them to those in their donors.MethodsIn this retrospective cross-sectional survey, background information and blood examination results were collected from the donors just before donation and after transplantation in the donors and recipients. Associations between UA and sex estimated glomerular filtration rate (eGFR), and body mass index (BMI) were evaluated. Data were assessed by the Wilcoxon rank-sum test for continuous variables and the chi-squared test for categorical variables; multiple linear regression analyses were performed to determine which factors were associated with renal function before and after transplantation.ResultsParticipant characteristics were as follows. The mean donor age (n = 45, 16 men and 29 women) was 55 ± 11 years, and the mean recipient age (n = 45, 25 men and 20 women) was 46 ± 16 years. Sex-related differences (UA levels in men were predominant) existed in the UA of donors before (P < 0.001) and after donation (P < 0.001). Conversely, there were no significant sex-related differences in the UA of recipients (P = 0.51); the mean standardized eGFRs were similar in donors and recipients after transplantation. Multivariate linear regression analysis showed donor UA only correlated with donor sex before donation (P = 0.008). After donation, donor UA was associated with donor sex (P = 0.006), eGFR (P < 0.001), and BMI (P = 0.02). Notably, the UA of recipients after transplantation was only associated with eGFR (P = 0.003).ConclusionsSex has less impact on UA in recipients than in donors. UA has a greater impact on renal prognosis in women than men, even at the same UA level. Therefore, attention should be given to UA levels in female recipients. These findings can be useful for determining patient prognosis following kidney transplantation in both donors and recipients.
Highlights
Higher serum uric acid (UA) levels are associated with poorer renal prognosis
Postmenopausal women have elevated serum UA levels, which can be explained by higher levels of estrogenic compounds in the serum [2]; estrogen promotes the excretion of UA from the kidney [3]
Discussion there were no significant differences in standardized estimated glomerular filtration rate (eGFR) between the donors and the recipients after kidney transplantation in the present study, modulating factors of serum UA levels might be different in both groups
Summary
Higher serum uric acid (UA) levels are associated with poorer renal prognosis. In kidney transplantation, both donors and recipients are diagnosed as having chronic kidney diseases (CKD) based on renal function; their UA levels slightly vary. Serum uric acid (UA) levels are affected by renal function and lifestyle factors, such as diet and body size [1]. In patients with chronic kidney disease (CKD), elimination of UA is significantly affected by deteriorating renal function, and administration of drugs, such as diuretics [4, 5]. Higher serum UA levels may be associated with poorer renal prognosis and adequate intervention is often necessary, especially in CKD patients [4]. Urate-lowering drugs, such as xanthine oxidase inhibitors (XO inhibitors), may be prescribed to CKD patients to delay the progression of renal dysfunction in patients with hyperuricemia [7, 8]
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