THE EFFECT OF HYPERURICEMIA AND ALLOPURINOL ON OUTCOME OF KIDNEY
TRANSPLANT RECIPIENTS
Abstract
OBJECTİVE: Kidney transplant recipients (KTRs) may have increased serum
uric acid (SUA) level due to presence of existing greft dysfunction and
used immunosuppressives. In this retrospective study, we evaluated
effect of high SUA levels and allopurinol therapy in KTRs on renal
functions. PATIENTS and METHODS: 113 KTRs of 233 KTRs included, had
elevated SUA level (G1). Fiftyseven of G1 received allopurinol treatment
(G1A+) and 56 patients (G1A-) did not. 56 of 118 patients who were
followed for five years (G5) were hyperuricemic (G5-1) and 26 of G5-1
treated with allopurinol (G5-1A+) and 30 of them did not (G5-1A-). 62
patients were normourisemic (G5-2). RESULTS: Of the 233 patients
included the mean age was 42.8±11.6 (17-76), 164 were male (70.0%). In
2. year graft loss developed in 9 (7.5 %) and 18 (15.9%) of G2 and G1
respectively (p = 0.045). According to allopurinol therapy 10 of the
graft loss occurred in the G1A+ and 8 in the G1A- (p=0,330). Graft loss
occurred in 12 (21%) and 9 (14%) in G5-1 and G5-2 respectively (p =
0.62). Graft loss occurred in 7 (23 %) and 5 (19%) in G5-1A+ and
G5-1A- respectively P = 0.71). Considering the first 2 in G5; in G5-1
graft loss was higher than in the G5-2 (p = 0.023), and higher SUA
levels increased the graft loss by 3.6 times compared to normal SUA
levels (95% confidence interval: 1,2-12.70). CONCLUSION: There was a
significant relationship between high SUA levels and graf loss in kidney
transplant recipients in 2 years and 5 years. Treatment of high SUA with
alIopurinol therapy had protective effect on renal functions. So that
hyperuricemia should be treated and low dose allopurinol can be option
for treatment of hyperuricemia therefore prevention of loss of kidney
function in kidney transplant recipients.