Major adverse cardiovascular events and hyperuricemia as an effect-modifying factor in kidney transplant recipients

doi:10.5500/wjt.v15.i3.102287

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World Journal of Transplantation

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2220-3230

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Transplant. Sep 18, 2025; 15(3): 102287
Published online Sep 18, 2025. doi: 10.5500/wjt.v15.i3.102287

Major adverse cardiovascular events and hyperuricemia as an effect-modifying factor in kidney transplant recipients

Elizabete Junk, Lilian Tzivian, Inese Folkmane, Kristofs Folkmanis, Janis Jushinskis, Gunta Strazda, Valdis Folkmanis, Viktorija Kuzema, Aivars Petersons

Elizabete Junk, Department of Internal Diseases, St. Bonifatius Hospital Lingen, Lingen 49808, Germany

Elizabete Junk, Lilian Tzivian, Inese Folkmane, Kristofs Folkmanis, Gunta Strazda, Valdis Folkmanis, Faculty of Medicine and Life Sciences, University of Latvia, Riga LV-1004, Latvia

Lilian Tzivian, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University of Dusseldorf, Düsseldorf 40225, Germany

Inese Folkmane, Viktorija Kuzema, Centre of Nephrology, Pauls Stradiņš Clinical University Hospital, Riga LV-1002, Latvia

Kristofs Folkmanis, International Center for Robotic Urology, Kreisklinikum Siegen, Siegen 57076, North Rhine-Westphalia, Germany

Janis Jushinskis, Centre of Transplantation, Pauls Stradiņš Clinical University Hospital, Riga LV-1002, Latvia

Janis Jushinskis, Viktorija Kuzema, Aivars Petersons, Faculty of Medicine, Riga Stradins University, Riga LV-1007, Latvia

Co-first authors: Elizabete Junk and Lilian Tzivian.

Author contributions: Junk E, Tzivian L, and Folkmane I were responsible for methodology, writing review and editing; Junk E and Tzivian L were responsible for formal analysis; Junk E, Tzivian L, and Folkmanis V were responsible for writing original draft preparation; Junk E and Folkmane I were responsible for conceptualization; Junk E, Folkmane I, Jushinskis J, Strazda G, and Kuzema V were responsible for investigation; Junk E and Folkmanis K were responsible for data curation; Tzivian L was responsible for software and validation; Folkmane I, Jushinskis J, Kuzema V, and Petersons A were responsible for resources; Folkmane I, Strazda G, and Petersons A were responsible for supervision; all of the authors read and approved the final version of the manuscript to be published.

Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Scientific Research Ethics Committee of the Institute of Cardiology and Regenerative Medicine of the University of Latvia (No. 5/2021).

Informed consent statement: Informed consent was obtained from all subjects involved in the study.

Conflict-of-interest statement: The authors declare no conflicts of interest.

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.

Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at folkmane.inese@inbox.lv. Participants’ informed consent for data sharing was not obtained but the presented data are anonymized and risk of identification is low.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Inese Folkmane, MD, PhD, Professor, Centre of Nephrology, Pauls Stradiņš Clinical University Hospital, Pilsoņu 13, Riga LV-1002, Latvia. folkmane.inese@inbox.lv

Received: October 13, 2024
Revised: January 31, 2025
Accepted: February 20, 2025
Published online: September 18, 2025
Processing time: 186 Days and 13.1 Hours

Core Tip

Core Tip: The relationship between hyperuricemia (HU) and major adverse cardiovascular (CV) events (MACEs) after kidney transplantation (KT) remains a topic of contention. We investigated the association between potential CV risk factors related to KT and MACEs, and their potential modification by HU. A very high level (> 475 μmol/L) of uric acid was found to act as an effect-modifying factor for MACEs, especially when combined with other risk factors such as previous CV events and anemia. This study makes an innovative contribution to the field by demonstrating the role of HU as a modulating factor on MACEs after KT.