Uric acid has a J-shaped association with cardiovascular and all-cause mortality in kidney transplant recipients

作者：Dahle Dag Olav^*; Jenssen Trond; Holdaas Hallvard; Leivestad Torbjorn; Vardal Mari; Mjoen Geir; Reisaeter Anna V; Toft Ingrid; Hartmann Anders

来源：Clinical Transplantation, 2014, 28(1): 134-140.

DOI：10.1111/ctr.12290

• kidney transplant recipients
• mortality
• uric acid

The association between serum uric acid and kidney graft and recipient survival is uncertain. During 2000-2011, we measured serum uric acid at week 10 after transplantation. Of 2748 transplanted patients, 2200 (80.1%) attended this visit. After a median follow-up of 7.4yr, 378 patients had died, 143 from a cardiovascular cause, and 185 patients lost their graft. The third quintile of uric acid levels (357-405M) had the lowest mortality risk and was used as reference group. In Cox proportional hazard models adjusting for graft and patient characteristics, the fifth quintile of uric acid levels (>474M) was independently associated with cardiovascular mortality (hazard ratio [HR]=2.87 [1.55-5.32], p=0.001) and all-cause mortality (HR=1.57 [1.09-2.25], p=0.02). Also, the lowest quintile of uric acid levels (<309M) showed a trend toward increased risk of cardiovascular mortality (HR=1.79 [0.90-3.58], p=0.10) and all-cause mortality (HR=1.31 [0.89-1.93], p=0.18). The increased risk at low uric acid levels was confined to diabetic recipients. Uric acid was not associated with death-censored graft loss. In conclusion, uric acid has a J-shaped association with cardiovascular and all-cause mortality in kidney transplant recipients.

• 出版日期2014-1