Korean J Urol.  2009 Nov;50(11):1144-1150.

Changes and Implications of Serum Uric Acid Levels After Living-Donor Nephrectomy

• Lee SR
• Kim IG
• Lee JO
• Han BH

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.

Keyword

Uric acid; Living donors; Kidney transplantation; Glomerular filtration rate

MeSH Terms

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
Calcium
Cholesterol
Hemoglobins
Uric Acid

Figure

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  Fig. 1 Plots of the relationship between uric acid at 1 year after living donor nephrectomy and preoperative uric acid.

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  Fig. 2 Receiver operation characteristics curve for the preoperative serum uric acid demonstrated superior benefit for the postoperative serum uric acid (uric acid≥6.8 mg/dl).

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