11 research outputs found
Serum Uric Acid and Renal Transplantation Outcomes: At Least 3-Year Post-transplant Retrospective Multivariate Analysis
<div><p>Since the association of serum uric acid and kidney transplant graft outcome remains disputable, we sought to evaluate the predictive value of uric acid level for graft survival/function and the factors could affect uric acid as time varies. A consecutive cohort of five hundred and seventy three recipients transplanted during January 2008 to December 2011 were recruited. Data and laboratory values of our interest were collected at 1, 3, 6, 12, 24 and 36 months post-transplant for analysis. Cox proportional hazard model, and multiple regression equation were built to adjust for the possible confounding variables and meet our goals as appropriate. The current cohort study lasts for 41.86 ± 15.49 months. Uric acid level is proven to be negatively associated with eGFR at different time point after adjustment for age, body mass index and male gender (standardized β ranges from -0.15 to -0.30 with all P<0.001).Males with low eGFR but high level of TG were on CSA, diuretics and RAS inhibitors and experienced at least one episode of acute rejection and diabetic issue were associated with a higher mean uric acid level. Hyperuricemia was significantly an independent predictor of pure graft failure (hazard ratio=4.01, 95% CI: 1.25-12.91, P=0.02) after adjustment. But it was no longer an independent risk factor for graft loss after adjustment. Interestingly, higher triglyceride level can make incidence of graft loss (hazard ratio=1.442, for each unit increase millimoles per liter 95% CI: 1.008-2.061, P=0.045) and death (hazard ratio=1.717, 95% CI: 1.105-2.665, P=0.016) more likely. The results of our study suggest that post-transplant elevated serum uric acid level is an independent predictor of long-term graft survival and graft function. Together with the high TG level impact on poor outcomes, further investigations for therapeutic effect are needed.</p></div
Journal of Mennonite studies
<p>All eGFRs of the 5 patients are lower than 10. One of them was having an acute rejection when tested for eGFR, the other 4 patients were experiencing DGF, 2 of them returned to dialysis eventually and the other 2 had recovered 2 months later. (A) The group of recipients went through allograft failure or death eventually. (B) The group of patients only suffered allograft failure.</p
Factors could impact UA level and risk factors for hyperuricemia.
<p>Abbreviations as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0133834#pone.0133834.t001" target="_blank">Table 1</a>; variables assignment for logistic regression: Dialysis type (prensence for peritoneal; lack for hemodialysis)</p
Kaplan-Meier survival curve estimates for pure graft survival.
<p>Excluding the dead with functioning kidney, we could observe greater variance between the two groups.</p
Hazard ratios of graft loss, graft failure, and death with UA/hyperuricemia in Cox proportional hazard models.
<p>Graft loss includes allograft failure and death; multivariate variables include: age, gender, BMI, HLA mismatch, introduction regimen, immunosuppressive agent protocol, diabetic mellitus, dialysis type, DGF, infection and acute rejection episode; abbreviations as previous tables; HR, hazard ratio.</p
1-month post-transplant eGFRs and UAs for patients of different outcomes.
<p>All P values are the results compared with recipients with nice prognosis group.</p
Kaplan-Meier survival curve estimates for graft loss.
<p>Hyperuricemic group survival curve was significantly (P = 0.007) lower than that of normouricemic group.Graft loss was defined as graft failure (return to dialysis) or death with functioning graft.</p
Demographic characteristics and laboratory findings of the recruited patients.
<p>BMI: Body mass index; HTN: Hypertension; GN: Glomerulonephritis; AAN: Aristolochic acid nephropathy; Basi: Basiliximab; Dacl: Daclizumab; DGF: delayed graft function SCr: Serum creatinine TC: Total cholesterol; TG: Triglycerides;</p
General information of recruited donors.
<p>Abbreviations as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0133834#pone.0133834.t001" target="_blank">Table 1</a>. Two types of donors we recruited are basically comparable in renal function, age and BMI.</p
Kaplan-Meier survival curve estimates for death with functioning graft.
<p>No significant difference can be acquired on patient survival rate between these groups.</p