Hyperuricemia, gout, and renal function after liver transplantation

Background. Hyperuricemia is a recognized complication of renal and cardiac transplantation, but the development of hyperuricemia and gout following l iver transplantation have received less attention. We have retrospectively assessed the prevalence of hyperuricemia in 134 consecutive liver transplan t recipients. Results. Forty-seven percent of the liver transplant recipients studied had hyperuricemia. Serum creatinine was higher in hyperuricemic than in nonhyp eruricemic patients. Peak uric acid correlated significantly with correspon ding serum creatinine (r(s)=0.694). Only 6% developed gout. All the patient s with gout and 10 hyperuricemic patients with renal impairment but without gout were treated with allopurinol. Over a median period of 3 months, mean serum creatinine fell from 177 mu mol/l to 160 mu mol/l (P=0.01), without change in type or dose of immunosuppression. Conclusions. There is an important association between liver transplantatio n and hyperuricemia. Treatment with allopurinol results in a significant re duction in serum creatinine in patients with gout and in those with hyperur icemia and renal impairment.