肾移植后无症状高尿酸血症对移植肾功能的影响

Effect of asymptomatic hyperuricemia after kidney transplantation on kidney function of graft

目的 探讨肾移植后无症状高尿酸血症对移植肾功能的影响.方法 回顾性分析2010年1月至2015年3月144例稳定期的肾移植受者的随访资料,根据血尿酸(SUA)水平将研究对象分为三组,工组为血尿酸正常组,Ⅱ组为无症状高尿酸血症组,经治疗后SUA平均值≤360μmol/L,Ⅲ组同样为无症状高尿酸血症组,但经治疗后SUA平均值>360μmol/L.分析和比较三组受者间术后12~84个月的血肌酐水平、估计肾小球滤过率(eGFR)等肾功能指标.结果 Ⅲ组术后12~84个月各监测时点均明显高于Ⅰ组(P<0.01);Ⅱ组术后24~36个月均明显高于Ⅰ组(P<0.01);与Ⅱ组相比较,Ⅲ组受者术后12个月后的SUA水平均显著高于Ⅱ组(P<0.05).Ⅲ组受者的血肌酐水平均显著高于同期Ⅰ组和Ⅱ组(P<0.05,P<0.01),与Ⅰ组相比,Ⅱ组受者的血肌酐水平虽有升高,但差异均无统计学意义(P>0.05).Ⅲ组受者的eGFR水平均显著低于同期的Ⅰ组和Ⅱ组(P<0.05).与Ⅰ组相比,Ⅱ组受者的eGFR较低,但两组间除术后60个月时eGFR的差异有统计学意义(P<0.05)外,其余时点的差异均无统计学意义(P>0.05).结论 肾移植术后无症状高尿酸血症可导致移植肾功能受损;经治疗后SUA得到控制的受者,其移植肾功能与无高尿酸血症的受者相当.

Objective To investigate the effect of asymptomatic hyperuricemia after renal transplantation on renal function of the grafts.Methods The follow-up data were retrospectively collected and analyzed in 144 patients with renal transplantation from January 2010 to March 2015.The patients were classified into three groups according to the level of serum uric acid (SUA):group A (normal group),group B (asymptomatic hyperuricernia with average SUA less than or equal to 360 μmol/L after treatment),and group C (asymptomatic hyperuricemia with average SUA greater than 360μmol/L after treatment).The renal function indexes such as serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) were compared among three groups from 12 to 48 months after transplantation.Results The SCr and eGFR showed no significant difference between group A and group B at 12th month (P>0.05),but ther are superior than Group Ⅲ (P<0.05).Conclusion After renal transplantation,asymptomatic hyperuricemia can lead to impaired renal function,and there are no significant differences in renal function between renal transplant recipients with normal SUA levels after treatment and those without hyperuricemia.