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Uric Acid Levels Have No Significant Effect on Renal Function in Adult Renal Transplant Recipients: Evidence from the Symphony Study

Herwig-Ulf Meier-Kriesche^*, Jesse D. Schold^*, Yves Vanrenterghem, Philip F. Halloran, and Henrik Ekberg

^* Department of Medicine, University of Florida, Gainesville, Florida; Department of Nephrology and Renal Transplantation, University Hospital Gasthuisberg, Leuven, Belgium; Division of Nephrology and Transplantation Immunology, University of Alberta, Edmonton, Alberta, Canada; and Department of Nephrology and Transplantation, University Hospital, Malmö, Sweden

Correspondence: Dr. Henrik Ekberg, Department of Nephrology and Transplantation, University Hospital, S-205 02 Malmö, Sweden. Phone: +46 40 33 10 00; Fax: +46 40 33 62 11; E-mail: henrik.ekberg{at}med.lu.se

Background and objectives: Uric acid (UA) has been linked to renal damage in experimental models of kidney failure. In humans, no definitive link between UA and renal function has been established, but several epidemiologic studies have suggested that higher UA levels are associated with accelerated loss of renal function, higher incidence of dialysis, and death. Many of the associations have been limited by the colinearity between UA levels and renal function. Renal transplantation is no exception, and limited information is available concerning the independent role of UA on progression of renal function in transplant recipients.

Design, setting, participants, & measurements: We investigated the association between UA and renal function progression during the first 3 yr after transplantation, adjusted for baseline renal function, in 1645 patients who were enrolled in the Symphony study.

Results: When corrected for baseline renal function, UA levels 1 mo after transplantation were not associated with 3-yr renal function (P = 0.62). There was a strong colinearity between calculated renal function and UA levels 1 mo after transplantation. In fact, when not corrected for baseline renal function, there was a significant association between UA and renal function at 3 yr (P = 0.005).

Conclusions: Low renal function is associated with higher UA levels, but higher UA levels are not independently associated with progression of renal dysfunction after kidney transplantation.