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Related Experiment Videos

Hyperuricemia after renal transplantation.

P F Gores1, D S Fryd, D E Sutherland

  • 1Department of Surgery, University of Minnesota, Minneapolis.

American Journal of Surgery
|November 1, 1988
PubMed
Summary

Hyperuricemia, common in kidney transplant patients on cyclosporine, does not harm graft function or survival. Asymptomatic high uric acid levels do not require treatment or prevent diuretic use.

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Area of Science:

  • Nephrology
  • Immunology
  • Pharmacology

Background:

  • Hyperuricemia is frequent in renal allograft recipients treated with cyclosporine.
  • The impact of hyperuricemia on renal allograft function remains understudied.
  • Previous reports suggested an increased gout incidence with combined cyclosporine and diuretic therapy.

Purpose of the Study:

  • To investigate the effect of hyperuricemia on renal allograft function and graft survival.
  • To compare the incidence of hyperuricemia between two immunosuppressive regimens.
  • To assess the association between hyperuricemia, diuretic use, and clinical gout.

Main Methods:

  • Prospective, randomized trial comparing cyclosporine/prednisone with azathioprine/prednisone/antilymphocyte globulin.

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  • Monitoring of serum uric acid levels and clinical diagnosis of gout.
  • Assessment of renal allograft function (serum creatinine) and 4-year graft survival rates.

    • Main Results:

    • Hyperuricemia occurred in 80% of cyclosporine/prednisone patients versus 55% in the other group (p<0.002).
    • Severe hyperuricemia (uric acid >14 mg/dl) occurred in 10% of cyclosporine/prednisone patients.
    • Clinical gout was rare (6 patients) and not significantly associated with severe hyperuricemia or diuretic use.
    • Severely hyperuricemic patients had similar serum creatinine levels and a 90% 4-year graft survival rate compared to normouricemic patients.

    Conclusions:

    • Asymptomatic hyperuricemia in renal transplant recipients does not adversely affect allograft function or survival.
    • Specific therapy for asymptomatic hyperuricemia is not indicated.
    • Hyperuricemia is not a contraindication for diuretic use in these patients.