Abstract: TH-PO942

The Impact of Hyperuricemia in Transplanted Kidney in Women

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Nakada, Yasuyuki, The Jikei University School of Medicine, Tokyo, Japan
  • Yamamoto, Izumi, The Jikei University School of Medicine, Tokyo, Japan
  • Katsumata, Haruki, The Jikei University School of Medicine, Tokyo, Japan
  • Unagami, Kohei, Tokyo Women's Medical University, Tokyo, Japan
  • Okumi, Masayoshi, Tokyo Women's Medical University, Tokyo, Japan
  • Ishida, Hideki, Tokyo Women's Medical University, Tokyo, Japan
  • Yokoo, Takashi, The Jikei University School of Medicine, Tokyo, Japan
  • Tanabe, Kazunari, Tokyo Women's Medical University, Tokyo, Japan
Background

The progression of arteriolar hyalinosis (AH) and interstitial fibrosis / tubular atrophy (IF/TA) is closely associated with graft failure in patients with kidney transplantation. Several clinical factors (aging, hypertension, diabetes, calcineurin inhibitor) influence this mechanism but the significance of hyperuricemia (HUA) was not fully understood. We here postulated that the HUA could influence AH and IF/TA progression in kidney allograft recipients.

Methods

We evaluated 126 recipients who received kidney transplants from January 2005 to December 2009 at the Department of Urology, Tokyo Women's Medical University. Patients with diabetes mellitus were excluded. AH and IF/TA progression were defined if Banff scores inceased more than one. HUA was defined as serum UA >7.0 mg/dL in males and >6.0 mg/dL in females. Survival analysis methods including Kaplan-Meier and Cox Proportional Hazard Model were used to evaluate the independent association of the UA burden over time (the average annual level of s-UA) with pathological progression, after adjustment for baseline covariates (age, gender, BMI, blood pressure, serum CNI concentration, baseline UA in serum).

Results

Hyperuricemic recipients were shown to have a higher cumulative progression of IF/TA (log-rank: p = 0.01) but not AH (log-rank: p = 0.76). HUA was found to be a significant predictor for the progression of IF/TA (HR: 1.71, p = 0.01). These trends were observed only in females (log-rank: p = 0.03) but not in males (log-rank: p = 0.19).

Conclusion

The impact of HUA on pathological deterioration is greater in females than males, suggesting the importance of more cautious management of HUA in females.