International Journal of Nephrology (Jan 2015)

Prognostic Value of Serum Uric Acid in Patients on the Waiting List before and after Renal Transplantation

  • Henrique Cotchi Simbo Muela,
  • Jose Jayme Galvão De Lima,
  • Luis Henrique W. Gowdak,
  • Flávio J. de Paula,
  • Luiz Aparecido Bortolotto

DOI
https://doi.org/10.1155/2015/375606
Journal volume & issue
Vol. 2015

Abstract

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Background. High serum uric acid (UA) is associated with increased cardiovascular (CV) risk in the general population. The impact of UA on CV events and mortality in CKD is unclear. Objective. To assess the relationship between UA and prognosis in hemodialysis (HD) patients before and after renal transplantation (TX). Methods. 1020 HD patients assessed for CV risk and followed from the time of inception until CV event, death, or TX (HD) or date of TX, CV event, death, or return to dialysis (TX). Results. 821 patients remained on HD while 199 underwent TX. High UA (≥428 mmol/L) was not associated with either composite CV events or mortality in HD patients. In TX patients high UA predicted an increased risk of events (P=0.03, HR 1.6, and 95% CI 1.03–2.54) but not with death. In the Cox proportional model UA was no longer significantly associated with CV events. Instead, a reduced GFR (<50 mL/min) emerged as the independent risk factor for events (P=0.02, HR 1.79, and % CI 1.07–3.21). Conclusion. In recipients of TX an increased posttransplant UA is related to higher probability of major CV events but this association probably caused concurrent reduction in GFR.