Major adverse cardiovascular events and hyperuricemia as an effectmodifying factor in kidney transplant recipients  

作　　者：Elizabete Junk Lilian Tzivian Inese Folkmane Kristofs Folkmanis Janis Jushinskis Gunta Strazda Valdis Folkmanis Viktorija Kuzema Aivars Petersons 

机构地区：[1]Department of Internal Diseases,St.Bonifatius Hospital Lingen,Lingen 49808,Germany [2]Faculty of Medicine and Life Sciences,University of Latvia,Riga LV-1004,Latvia [3]Institute of Occupational,Social and Environmental Medicine,Centre for Health and Society,Medical Faculty and University Hospital Düsseldorf,Heinrich-Heine-University of Dusseldorf,Düsseldorf 40225,Germany [4]Centre of Nephrology,Pauls StradiņšClinical University Hospital,Riga LV-1002,Latvia [5]International Center for Robotic Urology,Kreisklinikum Siegen,Siegen 57076,North Rhine-Westphalia,Germany [6]Centre of Transplantation,Pauls StradiņšClinical University Hospital,Riga LV-1002,Latvia [7]Faculty of Medicine,Riga Stradins University,Riga LV-1007,Latvia

出　　处：《World Journal of Transplantation》2025年第3期135-147,共13页世界移植杂志(英文)

摘　　要：BACKGROUND Major adverse cardiovascular(CV)events(MACEs)are the primary cause of morbidity and mortality in kidney transplantation(KT)recipients.The risk for MACEs is impacted by an array of traditional and transplant-related non-traditional CV risk factors.AIM To investigate the association between potential CV risk factors related to KT and MACEs,and their potential modification by hyperuricemia(HU).METHODS The relationship between CV risk factors related to KT and MACEs was examined in a cohort of 545 patients who underwent transplantation between 2008 and 2019.The mean age of patients at KT was 55.0 years±14.2 years(range 15.0–89.0 years).Univariate and multivariate logistic regression models were constructed to identify risk factors influencing MACEs.To explore the potential effect modification by uric acid(UA),patients were categorized into groups based on UA levels:(1)Low(<356μmol/L);(2)Normal(356–416μmol/L);(3)High(416–475μmol/L);and(4)Very high(>475μmol/L).RESULTS MACEs occurred in 145 of 545(26.6%)KT recipients.The most prevalent comorbidities were hypertension(87%),dyslipidemia(78%),secondary hyperparathyroidism(68%),HU(63%)and anemia(33%).In the multivariate logistic regression model,the most significant factors associated with MACEs were previous CV events[odds ratio(OR)=70.6,95%CI:24.9–200.1],left ventricular hypertrophy(LVH)(OR=12.6,95%CI:2.7–58.3),HU treatment(OR=4.3,95%CI:2.4–7.6),and anemia(OR=5.3,95%CI:2.9–9.8).Effect modification by the presence of HU revealed that independent factors associated with MACEs were age(OR=1.03,95%CI:1.0–1.1),previous CV events(OR=41.7,95%CI:13.6–127.6),LVH(OR=15.3,95%CI:2.0–116.6),HU treatment(OR=2.5,95%CI:1.3–4.6)and anemia(OR=5.4,95%CI:2.8–10.5).Effect modification by UA levels dichotomized at 475μmol/L(very high level of UA)revealed that HU treatment was not associated with MACEs in groups with or without very high UA levels.CONCLUSION A very high level of UA was observed to act as an effect-modifying factor for MACEs,especially wh

关 键 词：Kidney transplantation HYPERURICEMIA Uric acid Cardiovascular risk Major adverse cardiovascular events Effect modification by hyperuricemia Hyperuricemia treatment 

分 类 号：R699.2[医药卫生—泌尿科学]