THE RELATIONSHIP BETWEEN URIC ACID LEVELS AND GRAFT FUNCTION IN RENAL
TRANSPLANT PATIENTS WHO DISCONTINUED STEROID THERAPY
Abstract
Introduction: High uric acid levels are commonly encountered in kidney
transplant recipients, and can be associated with allograft dysfunction.
Our study aims to examine the relationship between UA levels and graft
function in patients discontinuing steroids. Methods: In this
single-center-retrospective study, 56 patients from among 678 RT
patients transplanted from living donors between 1999-2020 were
included. Causes of steroid discontinuation, creatinine levels
concurrent with uric acid levels before and after steroid
discontinuation (mean 3.9 ± 2.1 years), acute rejection numbers,
demographics, durations of dialysis and transplantation, medications
(d.a. use of immunosuppressive, antihypertensive), laboratory data,
human leukocyte antigen (HLA) mismatch numbers, blood-pressure [BP],
body mass index, late acute rejection (LAR) numbers (3 months
post-transplantation) were all recorded. Results: Creatinine and uric
acid levels were seen to have increased after steroid discontinuation,
there was a significant relationship between them (p<0.001).
Statistically significant correlation was found between increased
creatinine levels after steroid discontinuation and graft survival with
higher HLA mismatch; 39 (69.6%) patients with mismatch ≥2, and 17
patients with mismatch <2 (30.4%) (p=0.049) . No significant
relationship was found between LAR numbers before and after steroid
discontinuation, and creatinine levels after steroid discontinuation. In
conclusion, per model obtained as a result of multivariate linear
analysis, hyperuricemia and HLA mismatch numbers (p= 0.048 and p= 0.044,
respectively) are independent predictive factors for graft dysfunction
in patients discontinuing steroids. Accordingly, negative effects of
modeling should be kept in mind for long-term graft survival in patients
who plan to continue with steroid-sparing regimens.