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Hyperuricemia in Living Donor Kidney Transplantation Patients During Mizoribine Administration Caused Mainly by

Yi Shi1, Hang Liu2, Xin-Guo Chen3

  • 1Department of Urology, Beijing Tsinghua Changgung Hospital, Beijing, China; Organ Transplantation Center, Tianjin First Center Hospital, Tianjin, China.

Transplantation Proceedings
|June 4, 2019
PubMed
Abstract

Insights

Mizoribine (MZR) can cause hyperuricemia in transplant patients, often within months. This study suggests temporary kidney function changes, not MZR levels, are the primary cause of elevated uric acid.

Area of Science:

  • Nephrology
  • Pharmacology
  • Immunology

Background:

  • Mizoribine (MZR) is an immunosuppressant used post-renal transplantation.
  • Hyperuricemia is a reported side effect of MZR, typically emerging within months of administration.
  • MZR is renally excreted, raising concerns about its blood concentration and kidney function.

Purpose of the Study:

  • To investigate the association between changes in renal function and the onset of hyperuricemia in patients receiving MZR.
  • To determine if MZR's pharmacokinetic profile, influenced by renal function, directly contributes to hyperuricemia.

Main Methods:

  • Serum uric acid (UA), creatinine (sCr), β2-microglobulin (β2-MG), and cystatin C (Cys-C) were monitored for approximately 3 months in 22 subjects.
  • Correlation coefficients were calculated for changes in serum UA against changes in sCr, β2-MG, and Cys-C at the onset of hyperuricemia.

Main Results:

  • Strong positive correlations were observed between changes in serum UA and changes in sCr (r=0.723), β2-MG (r=0.863), and Cys-C (r=0.548), all statistically significant (P < .001).
  • Serum UA and sCr levels peaked concurrently after MZR administration, indicating a consistent pattern.
  • The data suggests a direct relationship between declining renal function markers and rising uric acid levels.

Conclusions:

  • Hyperuricemia following MZR administration is primarily attributed to temporary alterations in kidney function.
  • These renal function changes, rather than MZR concentration itself, appear to be the main driver of elevated uric acid levels.
  • Monitoring kidney function is crucial for managing hyperuricemia in MZR-treated patients.

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