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THE RELATIONSHIP BETWEEN URIC ACID LEVELS AND GRAFT FUNCTION IN RENAL TRANSPLANT PATIENTS WHO DISCONTINUED STEROID THERAPY
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  • Hulya Colak,
  • Sibel Ersan,
  • Mehmet Tanrisev,
  • Banu Yilmaz,
  • Orcun Ural,
  • Zumrut Unal,
  • İsmail Sert
Hulya Colak

Corresponding Author:[email protected]

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Sibel Ersan
Republic of Turkey Ministry of Health Izmir Provincial Health Directorate Izmir University of Health Sciences Tepecik Training and Research Hospital
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Mehmet Tanrisev
Republic of Turkey Ministry of Health Izmir Provincial Health Directorate Izmir University of Health Sciences Tepecik Training and Research Hospital
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Banu Yilmaz
Republic of Turkey Ministry of Health Izmir Provincial Health Directorate Izmir University of Health Sciences Tepecik Training and Research Hospital
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Orcun Ural
Republic of Turkey Ministry of Health Izmir Provincial Health Directorate Izmir University of Health Sciences Tepecik Training and Research Hospital
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Zumrut Unal
Ege University Department of Textile Engineering
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İsmail Sert
Republic of Turkey Ministry of Health Izmir Provincial Health Directorate Izmir University of Health Sciences Tepecik Training and Research Hospital
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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.