Journal article
Hyperuricemia after orthotopic liver transplantation: divergent associations with progression of renal disease, incident endstage renal disease, and mortality
BMC nephrology, v 18, 103
27 Mar 2017
PMID: 28347282
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Although hyperuricemia is common after orthotopic liver transplantation (OLT), its relationship to mortality, progressive kidney disease, or the development of end stage renal disease (ESRD) is not well-described.
Methods: Data from 304 patients undergoing OLT between 1996 and 2010 were used to assess the association of mean serum uric acid (UA) level in the 3-months post-OLT with mortality, doubling of creatinine, and ESRD incidence. Post-OLT survival to event outcomes according to UA level and eGFR was assessed using the Kaplan Meier method and multivariate Cox proportional hazards models.
Results: Mean UA level among the 204 patients with an eGFR level >= 60ml/min/1.73m(2) was 6.4 mg/ dl compared to 7.9 mg/ dl among the 100 patients with eGFR < 60 (rho < 0.0001). During a median of 4.6 years of follow-up, mortality rate, doubling of creatinine, and ESRD incidence were 48.9, 278.2, and 20.7 per 1000 person-years, respectively. In the first 5 years of follow- up, elevated UA was associated with mortality (Hazard Ratio, HR = 1.7; rho = 0.045). However, among those with eGFR = 60, UA level did not predict mortality (HR = 1.0; rho = 0.95), and among those with eGFR < 60, elevated UA was a strong predictor of mortality (HR = 3.7[ 1.1, 12.0]; rho = 0.03). UA was not associated with ESRD, but was associated with doubling of creatinine among diabetics (HR = 2.2[ 1.1, 4.3]; rho = 0.025).
Conclusion: In this post-OLT cohort, hyperuricemia independently predicted mortality, particularly among patients with eGFR < 60, and predicted doubling of creatinine among diabetics.
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Details
- Title
- Hyperuricemia after orthotopic liver transplantation: divergent associations with progression of renal disease, incident endstage renal disease, and mortality
- Creators
- Joseph C. Longenecker - Kuwait UniversitySana Waheed - University of Wisconsin–MadisonGhassan Bandak - Mayo Clinic in ArizonaChristine A. Murakami - Lakelands Nephrol PA, Greenwood, SC USABlaithin A. McMahon - Johns Hopkins MedicineAllan C. Gelber - Johns Hopkins MedicineMohamed G. Atta - Johns Hopkins Medicine
- Publication Details
- BMC nephrology, v 18, 103
- Publisher
- Springer Nature
- Number of pages
- 11
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000397684600002
- Scopus ID
- 2-s2.0-85016161874
- Other Identifier
- 991022051415204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Urology & Nephrology