Hyperuricemia and gout are common metabolic and rheumatologic disorders among renal transplant recipients which may affect the graft outcome. To determine the prevalence of hyperuricemia and gout and correlation with various predisposing factors. We retrospectively analyzed the data from the medical records of 455 patients who had undergone renal transplantation in our center between 1998 and 2004. Follow up period was at least two years and patients with serum creatinine level <200 umol/l were included. Related demographic features and risk factors were studied every almost 6 months. Equal number of patients with same demographic features and normal serum uric acid level were taken as control.There were 40 patients with persistent hyperuricemia (8.7%) which were mainly adults (92.5%) and males (75%). Most patients were on cyclosporine (90%) and mycophenolate mofetil (80%). The incidence of hypertetension was 92.5% and calcium channel blockers were the most frequently used antihypertensive (75%) which was significantly different than the control group (p 0.05%). Patients receiving diuretics were 12.5%. Patients treated with atorvastatin had significantly less hyperuricemia (p 0.007) compared with others treated with simvastatin. None of these patients had gouty arthropathy and only 2.5% required uricosuric drugs. Acute rejection was reported in 32.5% out of which 70% were steroid resistant while biopsy proven chronic allograft nephropathy was detected in 10%of these patients. There were significant correlation between hyperuricemia and obesity and graft dysfunction during long term follow up.
Hyperuricemia is a clinical problem in post renal transplant recipients which is strongly correlated to type of immunosuppression, hypertension, obesity and certain drugs. It has an impact on the long-term outcome of the renal graft.