Abstract
Background: Many studies have been performed in kidney transplant recipients to test whether hyperuricemia plays a role in decreased kidney function, but the results have been controversial. We conducted a retrospective cohort study to assess the predictors of hyperuricemia and how uric acid (UA) influences glomerular filtration rate (GFR) changes. Methods: 556 patients who underwent kidney transplantation between January 1, 1990 and February 24, 2009, were included. Serum UA levels were routinely recorded every 3 months after transplantation. Hyperuricemia was defined as serum UA ≧6.0 mg/dl for women, and ≧7.0 mg/dl for men. A time-dependent covariate Cox model was used to assess the association of serial changes of estimated GFR (eGFR) and UA. Results: Multivariate analysis indicated that male gender, eGFR, and transplant duration were associated with higher mean UA levels. A time-dependent covariate Cox model indicated that initial eGFR level (hazard ratio: 1.001; p = 0.035) and previous UA level (hazard ratio: 1.454; p < 0.001) affected the subsequent eGFR level. Conclusions: Our results indicated a predictive relationship between UA and eGFR based on the results of a time-dependent covariate Cox model that elevated serum UA precedes a graft dysfunction in kidney transplant recipients.
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