Objective: Only living donation enables for timely kidney transplantation for patients with end stage renal disease. Donors's follow-up is often neglected, bringing up economic and ethical issues implications. This study aimed to investigate the association between hyperuricemia and histological alteration in implant biopsy, and donors renal function decline in after 1-year in living-kidney transplantation.
Methods: 261 living-donors who underwent kidney transplantation between Jan 2001 and Jan 2012 in our institute. We excluded donors, who could not follow 1-year after donation (n=168). Then we recruited donors with histological finding at 1-hour biopsy were studied (n=89). All of the remaining 89 donors (36 men and 53 women, aged 33 to 78 y/o) were studied. Hypertension was defined as >140/90mmHg and/or medication usage. Hyperuricemia was defined as uric acid≥5.0 mg/dl for women and ≥ 7.0 mg/dl for men and/or medication usage. Renal function decline was defined as eGFR sloping > -0.36ml/min/1.73m2/year (according to the CKD guideline in JSN). The data based on pre-donation were collected from the electric record. Histological abnormalities were defined as two points more of the following: a)>5% global glomerulosclerosis, b)>5% interstitial fibrosis with tubular atrophy, or c) any arteriosclerosis. Statistical analysis was used by Χ2-test and logistic regression models.
Results: Donation after 1-year, 41.5% donors (n=37) developed the renal function decline. Univariate model, SUA (OR 1.55[1.12-2.22], p=0.005), hypertension at donation (OR 2.5[1.06-6.14], p=0.03), and patient history of any one; hypertension, dyslipidemia, IGT (OR 2.8[1.13-7.37], p=0.02), hyperuricemia (OR 3.2[1.25-8.49], p=0.01) were associated with renal function decline in living-donor. Multivariate model (adjusted for age, hypertension, patient history), hyperuricemia (OR 2.92[1.10-8.06], p=0.03) was remained significant. Moreover, hyperuricemia was associated with histological abnormalities(OR 2.7 [1.04-7.19], p=0.03).
Conclusions: Hyperuricemia is associated with both histological abnormality in implant biopsy and independent risk factor of donors renal function decline after 1-year in living-kidney transplantation.
To cite this abstract in AMA style:Tanaka K, Sakai K, Nemoto T, Ohashi Y, Tanaka Y, Muramatsu M, Hyodo Y, Kawamura T, Shishido S, Aikawa A. Hyperuricemia Is Associated with Both Histological Alteration in Implant Biopsy and Risk Factor of Donor’s Renal Function Decline after 1-Year in Living-Kidney Transplantation [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/hyperuricemia-is-associated-with-both-histological-alteration-in-implant-biopsy-and-risk-factor-of-donors-renal-function-decline-after-1-year-in-living-kidney-transplantation/. Accessed September 24, 2017.
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