Changes and Implications of Serum Uric Acid Levels After Living-Donor Nephrectomy.
10.4111/kju.2009.50.11.1144
- Author:
So Ri LEE
1
;
In Gon KIM
;
Jeong Oh LEE
;
Bo Hyun HAN
Author Information
1. Department of Urology, Maryknoll Hospital, Busan, Korea. superpanda@freechal.com
- Publication Type:Original Article
- Keywords:
Uric acid;
Living donors;
Kidney transplantation;
Glomerular filtration rate
- MeSH:
Blood Pressure;
Body Mass Index;
Calcium;
Cholesterol;
Glomerular Filtration Rate;
Hematocrit;
Hemoglobins;
Humans;
Hyperuricemia;
Kidney;
Kidney Transplantation;
Living Donors;
Multivariate Analysis;
Nephrectomy;
Sensitivity and Specificity;
Tissue Donors;
Uric Acid
- From:Korean Journal of Urology
2009;50(11):1144-1150
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aim of this study was to investigate the changes in and implications of preoperative and postoperative serum uric acid levels in patients with living donor nephrectomy. MATERIALS AND METHODS: We studied 207 patients between 1998 and 2007 at our hospital undergoing living-donor nephrectomy for kidney transplantation. The serum uric acid level and estimated glomerular filtration rate (eGFR) were measured preoperatively and at 1 year postoperatively. We also analyzed multiple independent variables such as age, sex, blood pressure, body mass index (BMI), serum total cholesterol, hemoglobin, hematocrit, total protein, albumin, calcium, and phosphorus. RESULTS: The mean age of the study patients was 38.3+/-10.8 years. The mean serum uric acid concentration at 1 year after kidney donation was higher than preoperatively (5.05+/-1.39 mg/dl preoperatively vs. 5.85+/-1.14 mg/dl postoperatively) and was significantly greater in patients with hyperuricemia (uric acid> or =6.8 mg/dl) than in patients without hyperuricemia (uric acid < 6.8 mg/dl): 1.63+/-0.75 mg/dl vs. 0.69+/-0.66 mg/dl, respectively. The multivariate analysis showed that preoperative serum uric acid was the primary predictive factor of postoperative serum uric acid (r=1.136, p=0.001), and preoperative GFR was an independent secondary predictive factor (r=-0.004, p=0.047). The receiver operator characteristics (ROC) curves for the preoperative serum uric acid cutoff of 5.7 mg/dl showed the highest sensitivity and specificity of 96% and 86%, respectively. CONCLUSIONS: These results suggest that preoperative serum uric acid and GFR were important predictive factors of postoperative serum uric acid after living-donor nephrectomy. Therefore, in the selection and management of kidney donors, not only patients with a low GFR but also those with high uric acid (serum uric acid > or =5.7 mg/dl) require careful observation before and after living-donor nephrectomy.
