Investigating Serum Uric Acid as a Risk Factor in the Development of Delayed Renal Recovery in Living Kidney Donors.

Abstract

Background. Hyperuricemia has been associated with kidney disease and remains controversial with regard to its gender-specific differences and impact in living kidney donation.

Methods. Between 2006 and 2015, charts of live kidney donors who underwent nephrectomy and had a minimum follow-up of 1 year were reviewed. A total of 291 donors were included and divided based on gender-specific pre-donation serum uric acid (SUA) tertiles. Renal functional outcomes included were estimated glomerular filtration rate (eGFR) at 6-month and 1-year follow-up and percentage of donors with a 1-year eGFR < 60 mL/min/1.72 m(2). Logistic regression analysis was done.

Results. Mean SUA tertiles were 5.8 +/- 1.1 mg/dL in males and 4.1 +/- 1 mg/dL in females. Females in the highest tertile (SUA > 4.5 mg/dL) had lower 6-month (59.9 +/- 10.3 vs 66.9 +/- 14.1 vs 67.3 +/- 12.1; P = .018) and 1-year (60.8 +/- 10.6 vs 67.6 +/- 10.8 vs 67.8 +/- 11.8; P = .021) eGFR and a higher percentage of donors with 1-year eGFR < 60 mL/min/1.73 m(2) (59.5% vs 31.6% vs 23%; P = .002) compared with donors in the lower SUA tertiles (<= 4.5 mg/dL). In males, there were similar eGFRs among SUA tertiles at 6-month and 1-year follow-up. In multivariate analysis, SUA was shown to be a significant predictor of developing stage 3 CKD (eGFR < 60 mL/min/1.72 m(2)), 1 year after donation in females but not in males.

Conclusions. Predonation SUA level is associated with the development of delayed renal recovery (GFR < 60 mL/min/1.72 m(2)) 1 year after donation in females but not in males.