Abstract: SA-PO945
Major Cardiovascular Events and Hyperuricemia as an Effect-Modulating Factor in Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - 3
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Author
- Folkmane, Inese, Faculty of Medicine, University of Latvia, Riga, Latvia
Background
Major cardiovascular events (MACE) remain the leading cause of morbidity and mortality in patients with kidney transplants (KT). The risk for MACE is affected by the accumulation of a wide range of traditional and transplant-associated nontraditional cardiovascular (CV) risk factors (RFs). In the last years, studies have shown that many other cardiovascular RFs may be involved, including hyperuricemia (HU).
Methods
We investigated the association between CV risk factors related to KT with MACE, and their effect modification by HU in a cohort of 545 patients transplanted between 2008 to 2019. Univariate and multivariate Cox proportional hazards regression analyses were performed to determine the RFs associated with MACE. To investigate the possibility of effect modification of the uric acid (UA) for the associations of independent factors with MACE, patients were stratified as having a low (< 6 mg/dL), normal (6-7 mg/dL), high (7-8 mg/dL) and very high (> 8 mg/dL) UA level.
Results
MACE occurred in 145 of 545 (26.6 %) KT recipients. Most of the independent variables investigated in this study were univariately related to the MACE. On the multiple logistic regression main model that described 62.1% of changes in MACEs, the most prominent factors associated with MACE were previous CV event (OR = 70.6, 95% CI 24.9 – 200.1), left ventricular hypertrophy (LVH) (OR = 12.6, 95% CI 2.74 – 58.3), HU treatment (OR = 4.29, 95% CI 2.44 – 7.57), anemia (OR = 5.32, 95% CI 2.89 – 9.8). Effect modification by hyperuricemia showed that independent factors associated with MACE were age (OR = 1.03, 95% CI 1.03 – 1.09), previous CV events (OR = 41.70, 95% CI 13.62 – 127.64), LVH (OR = 15.33, 95% CI 2.02 – 116.60), HU treatment (OR = 2.45, 95% CI 1.31 – 4.59) and anemia (OR = 5.36, 95% CI 2.75 – 10.45). Effect modification by very high levels of UA showed that HU treatment was not associated with MACE either for those with or for those without very high levels of UA. The variables that were significantly associated with MACE for those with very high UA were previous CV events (OR = 72.82, 95% CI 9.09 – 583.34) and anemia (OR = 6.46, 95% CI 2.46 – 16.95).
Conclusion
HU was found to be an effect-modifying factor for MACE, especially in association with RFs such as age, previous CV events, LVH, and anemia.