Prevalence of Hyperuricemia in Adult Renal Transplant Patients at The Kenyatta National Hospital, Nairobi, Kenya

Abstract

Background: Hyperuricemia is prevalent in renal transplant recipients and has been shown to be a cause of adverse graft outcome  through its direct effects on the kidney and indirectly through its cardiovascular effects that can result in impaired graft function. Hyperuricemia is modifiable in renal transplant recipients.

Objective: To determine the burden of hyperuricemia and clinical features associated with it among patients attending the renal  transplant clinic at a tertiary hospital in Nairobi, Kenya.

Design: Cross sectional study.

Setting: Renal transplant clinic at the Kenyatta National hospital

Methods: A total of 96 patients were included in the study. Clinical characteristics, blood uric acid and creatinine levels  for the purpose of estimating the glomerular filtration rate were determined from renal transplant recipients greater than 6 months  posttransplant. Hyperuricemia was defined as serum uric acid of greater than 360 umol/l in females and greater 420 umol/l in males 

Results: The mean age of the patients was 46.4 (SD 14.3) years, mean post-transplant time was 5.9 (SD 5.3) years, mean creatinine was  135.5 (SD 117.6) umol/l. The prevalence of hyperuricemia was 40.6% (n=96). The patients were predominantly male at 65.6%. The most  common cause of End Stage Renal Disease (ESRD) was hypertension at 32%. Hyperuricemic patients had worse graft function (mean  eGFR 59.4 vs. 74.5 mL/min/1.73 m2 ; p=0.005), higher creatinine levels (116.0 vs. 98.0 umol/l; p=0.014), less likely to be diabetic patients  (12.8% vs. 33.3%, p=0.023), or be on insulin (7.7% vs. 29.8%; p=0.009).

Conclusion: Prevalence of post-transplant hyperuricemia is high,  particularly in those with higher creatinine and estimated Glomerular Filtration Rate (eGFR) and lower in diabetics and those who use insulin.

Recommendation: Screening for hyperuricemia should be done regularly for renal transplant recipients at the Kenyatta National  Hospital transplant clinic due to its high prevalence.