Effects of Hyperuricemia on Renal Function of Renal Transplant Recipients A Systematic Review and Meta-Analysis of Cohort Studies 英文参考文献.docVIP

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Effects of Hyperuricemia on Renal Function of Renal Transplant Recipients A Systematic Review and Meta-Analysis of Cohort Studies 英文参考文献.doc

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Effects of Hyperuricemia on Renal Function of Renal Transplant Recipients A Systematic Review and Meta-Analysis of Cohort Studies 英文参考文献

EffectsofHyperuricemiaonRenalFunctionofRenal TransplantRecipients:ASystematicReviewandMeta- AnalysisofCohortStudies YanHuang1,Yu-LinLi2,HeHuang3,LingWang4,Wen-MingYuan5,JingLi1* 1ChineseCochraneCenter,WestChinaHospital,SichuanUniversity,Chengdu,People’sRepublicofChina,2TheSecondClinicalMedicalCollegeofChengduUniversityof TCM,ChengduUniversityofTCM,Chengdu,People’sRepublicofChina,3DepartmentofCardiology,WestChinaHospital,SichuanUniversity,Chengdu,People’sRepublic ofChina,4DepartmentofCardiology,ThePeople’sHospitalofMianyang,Mianyang,People’sRepublicofChina,5DepartmentofNephrology,TheFirstAffiliatedHospital ofZhengzhouUniversity,ZhengzhouUniversity,Zhengzhou,People’sRepublicofChina Abstract Background:Hyperuricemiaisanindependentriskfactorofnephropathy,butitsroleinrenaltransplantrecipients(RTRs)is controversial. Methods: Based on the methods of Cochrane systematic reviews, we searched MEDLINE (1948–2011.6), EMBASE (1956– 2011.6),CBM(ChineseBiomedicineDatabase)(1978–2011.6)toidentifycohortstudiesassessingtheassociationbetween uricacidlevelandkidneyallograft.Twoauthorsindependentlyscreenedthestudies,assessedtheriskofbiasofincluded studies and extracted data. Unadjusted odds ratio(OR), mean difference (MD), adjusted hazard ratio (aHR) and their corresponding95%CIwerepooledtoassesstheeffectsofhyperuricemiaonkidneyallograft. Results:TwelvecohortstudieswereincludedandthequalitywasmoderatetohighbasedontheNEWCASTLE-OTTAWA quality assessment scale. RTRs with hyperuricemia had lower eGFR (P,0.0001, 95%CI216.34,6.14) and higher SCr (P,0.00001,95%CI0.17,0.31)thanthosewithnormaluricacidlevel.Meta-analysisshowedthathyperuricemiawasarisk factorofchronicallograftnephropathy(UnadjustedOR=2.85,95%CI1.84,4.38,adjustedHR=1.65,95%CI1.02,2.65)and graftloss(UnadjustedOR=2.29,95%CI1.55,3.39;adjustedHR=2.01,95%CI1.39,2.94). Conclusions: Current evidence suggests that hyperuricemia may be an independent risk factor of allograft dysfunction. Hyperuricemia may modestly increase the risk of poo