Association Between Nonadherence and Transient Hyperuricemia in Pediatric Kidney Transplantation

•Nonadherence among pediatric transplant recipients reduces graft survival.•Transient hyperuricemia is a risk factor for nonadherence after kidney transplant.•Monitoring for transient hyperuricemia may allow early detection of nonadherence. Nonadherence among pediatric transplant recipients is a sig...

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Bibliographic Details
Published in:Transplantation proceedings 2023-01, Vol.55 (1), p.129-133
Main Authors: Morizawa, Y., Satoh, H., Arai, M., Iwasa, S., Sato, A., Fujimoto, K.
Format: Article
Language:English
Subjects:
Child
Graft Survival
Humans
Hyperuricemia - etiology
Kidney
Kidney Transplantation - adverse effects
Retrospective Studies
Risk Factors
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Summary:•Nonadherence among pediatric transplant recipients reduces graft survival.•Transient hyperuricemia is a risk factor for nonadherence after kidney transplant.•Monitoring for transient hyperuricemia may allow early detection of nonadherence. Nonadherence among pediatric transplant recipients is a significant problem that reduces graft survival and leads to poor kidney graft outcomes. It is, however, extremely difficult to detect during a regular follow-up. This study, therefore, aimed to investigate the risk factors involved in nonadherence, focusing on unexplained transient hyperuricemia in pediatric kidney transplant (KTx) recipients at a single pediatric center. This retrospective study included 167 patients who underwent KTx at our pediatric center. A Cox proportional hazards analysis was performed to evaluate the risk of nonadherence using the following factors: age, sex, body mass index SD score, transient hyperuricemia, hypertension, and follow-up period. Nonadherence was identified in 19 patients (11%), with the average (SD) age and post-KTx duration at diagnosis being 17.21 (4.73) years and 79.21 (38.77) months, respectively. Thirty-four patients (20%) were diagnosed with transient hyperuricemia at a median of 14 months after KTx. On multivariate Cox regression analysis, transient hyperuricemia was the only independent risk factor for nonadherence after KTx. Transient hyperuricemia was identified as one of the risk factors for nonadherence after KTx; therefore, careful monitoring for transient hyperuricemia may allow early detection of nonadherence.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2022.09.033