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Association between post-transplant serum uric acid levels and kidney transplantation outcomes

 Deok Gie Kim  ;  Hoon Young Choi  ;  Ha Yan Kim  ;  Eun Ju Lee  ;  Kyu Ha Huh  ;  Myoung Soo Kim  ;  Chung Mo Nam  ;  Beom Seok Kim  ;  Yu Seun Kim 
 PLOS ONE, Vol.13(12) : e0209156, 2018 
Journal Title
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BACKGROUND: Serum uric acid (UA) level has been reported to be associated with chronic allograft nephropathy and graft failure in patients who undergo kidney transplantation (KT). However, the role of serum UA level in renal graft survival remains controversial.

OBJECTIVE: This study aimed to investigate the effect of mean serum UA level during two different post-KT periods on long-term renal graft outcomes in a large population cohort in which living donor KT prevails.

MATERIAL AND METHODS: A retrospective cohort study was performed using KT data prospectively collected at a single institution. Patients (n = 2,993) were divided into low-, normal-, and high-UA groups according to the mean serum UA level within the first year (1-YR) and 1-5 years (5-YR) after transplantation.

RESULTS: In the 1-YR Cox proportional hazards analysis, the low- and high-UA groups had a significantly decreased and increased risk, respectively, for overall graft failure (OGF), death-censored graft failure (DCGF), and composite event (return to dialysis, retransplantation, death from graft dysfunction, and 40% decline in estimated glomerular filtration rate) compared with the normal-UA group. Similarly, in the 5-YR analysis, the low-UA group had a significantly reduced risk of DCGF compared with the normal-UA group, whereas the high-UA group had a significantly increased risk of all three graft outcomes. In a marginal structural model, hyperuricemia had a significant causal effect on worsening graft outcomes, with consideration of all confounding variables (OGF: hazard ratio [HR] 2.27, 95% confidence interval [CI] 1.33-3.78; DCGF: HR 2.38, 95% CI 1.09-4.9; composite event: HR 3.05, 95% CI 1.64-5.49).

CONCLUSIONS: A low-to-normal serum UA level within the first year and 1-5 years after KT is an independent factor for better renal allograft outcomes in the long-term follow-up period rather than high serum UA level.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Deok Gie(김덕기)
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Beom Seok(김범석) ORCID logo https://orcid.org/0000-0002-5732-2583
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Kim, Ha Yan(김하얀)
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Choi, Hoon Young(최훈영) ORCID logo https://orcid.org/0000-0002-4245-0339
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
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