Copyright ©The Author(s) 2015.
World J Nephrol. Jul 6, 2015; 4(3): 324-329
Published online Jul 6, 2015. doi: 10.5527/wjn.v4.i3.324
Table 1 Studies investigating the association between serum uric acid and renal function/graft survival in patients with kidney transplantation
AuthorNumerosityAverage follow-up Major findingsRef.
Gerhardt et al (1999)3755 yrHyperuricemia (> 8.0 mg/dL in men and > 6.2 mg/dL in women), associated with reduced graft survival[12]
Armstrong et al (2005)902.2 yrUA independent predictor of follow-up eGFR, but not of eGFR change over time[13]
Akgul et al (2007)1333 yrNo association found between serum UA and the development of chronic allograft nephropathy[14]
Saglam et al (2008)34Not reportedSerum UA associated to development of cyclosporine A nephropathy (biopsy proven)[15]
Akalin et al (2008)3074.3 yrHyperuricemia 6 mo after transplantation significantly associated with new cardiovascular events and graft dysfunction[16]
Bandukwala et al (2009)4052 yrHyperuricemia associated with cardiovascular events, and, inversely with eGFR[17]
Meyer-Kriesche et al (2009)16453 yrUA levels one month after transplantation not associated with follow-up eGFR, after adjustment for baseline renal function[20]
Karbowska et al (2009)78Not reportedHyperuricemia associated with markers of endothelial dysfunction and inflammation[19]
Min et al (2009)36858 ± 23 moEarly-onset moderate-to-severe hyperuricaemia (serum UA ≥ 8.0 mg/dL) was found to be a significant risk factor for chronic allograft nephropathy (P = 0.035) and a poorer graft survival (P = 0.026) by multivariate analysis, whereas mild hyperuricaemia was not[18]
Haririan et al (2010)21268 ± 27 moSerum UA during the first 6 mo postransplant, is an independent predictor of graft survival[21]
Kim et al (2010)356102.6 ± 27.2 moPatients with eGFR> 60 mL/min per 1.73 m2. Hyperuricemia associated with decreased eGFR[10]
Boratyńska et al (2010)10034 ± 12 moSerum UA not associated to graft survival during 30 mo of follow-up[22]
Chung et al (2011)35110 yrHyperuricemia increased risk of cardiovascular complication; graft survival at 5 and 10 yr lower in hyperuricemic vs normouricemic patients (89% vs 96% and 81% vs 93% respectively, P = 0.02)[23]
Kim et al (2011)556Not reportedSerum UA levels affect graft function, even after adjustment for baseline eGFR[24]
Wang et al (2011)52410 yrRetrospective study: UA significantly lower in patients with longer graft survival[25]
Park et al (2013)428120 ± 58 moSerum UA associated with allograft loss, but rate of eGFR decline more potent predictor[26]
Choi et al (2013)37810 yrGraft survival (living donor renal transplantation) 88.6% in normouricemic vs 78.8% in hyperuricemic patients[27]
Dahle et al (2014)22007.4 yrHighest serum UA quintile independently associated with increased HR (2.87, 95%CI: 1.55-5.32) of cardiovascular and all-cause (1.55, 95%CI: 1.09-2.25) mortality[28]
Hart et al (2014)1495 yrPost-hoc study of the ABCAN trial. Serum UA independently associated with increased odds of composite outcome of doubling of interstitium or ESRD from Interstitial Fibrosis/Tubular Atrophy, after adjusting for eGFR[29]
Weng et al (2014)88043.3 ± 26.3 moHyperuricemia associated with poorer graft survival (60.5% vs 75.8%, P = 0.007), no difference in all-cause mortality[30]
Boratyńska et al (2014)63710 yrRetrospective study. Hyperuricemia associated with chronic allograft dysfunction[31]
Weng et al (2014)12414.3 moPatients undergoing biopsies for acute allograft dysfunction. Hyperuricemia associated with a greater cumulative incidence at one year of doubling serum creatinine or graft loss (29.8% vs 14.9%, P = 0.02) compared to normouricemia[32]
Table 2 Studies of uric-acid-lowering therapy in renal allograft recipients
Ref.Study populationAverage follow-upIntervention/outcome(s)Main study findings
Perez-Ruiz et al[34]279 renal allograft recipients with hyperuricemia38.6 ± 18.4 moAllopurinol, benziodarone/ serum UA levelsBoth drugs effective in lowering serum UA; benziodarone safer in patients on azathioprine
Numakura et al[11]121 renal allograft recipients with and without hyperuricemiaUp to 10 yr, mean not reportedAllopurinol/eGFR, graft survivalHyperuricemia associated with reduced eGFR, but graft survival similar in normo and hyperuricemic patients
Osadchuck et al[35]108 renal allograft recipients (54 patients treated vs 54 controls)2 yrAllopurinol/Serum UA levels, eGFR, graft survivalReduced serum UA, preservation of eGFR in allopurinol treated patients; no differences in graft survival and blood pressure
Sofue et al[36]93 renal allograft recipients (42 normouricemic, 51 hyperuricemic, 26 treated, 25 not treated)1 yrFebuxostat/serum UA levels, eGFRSerum UA lower and eGFR stable in patients treated with febuxostat
Tojimbara et al[38]23 renal allograft recipients with hyperuricemia12 ± 2 moFebuxostat/serum UA, eGFRSerum UA lower after treatment with febuxostat; eGFR stable