Characterization of Urate Metabolism and Complications of Patients with Renal Hypouricemia
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- Miyazaki Satoshi
- Division of Cardiology, Fujii Masao Memorial Hospital, Japan
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- Hamada Toshihiro
- Department of Community-based Family Medicine, Faculty of Medicine, Tottori University, Japan
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- Isoyama Tadahiro
- Department of Urology, Yonago Medical Center, Japan
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- Okada Shinichi
- Department of Pediatrics, Yonago Medical Center, Japan
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- Tomita Katsuyuki
- Department of Respiratory Disease, Yonago Medical Center, Japan
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- Endo Yusuke
- Advanced Medicine, Innovation and Clinical Research Center, Tottori University Hospital, Japan
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- Kuwabara Masanari
- Department of Cardiology, Toranomon Hospital, Japan
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- Sugihara Shinobu
- Department of Health Service Center, Shimane University, Japan
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- Ogino Kazuhide
- Department of Cardiology, Tottori Red Cross Hospital, Japan
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- Ninomiya Haruaki
- Department of Biological Regulation, Faculty of Medicine, Tottori University, Japan
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- Ichida Kimiyoshi
- Department of Pathophysiology, Tokyo University of Pharmacy and Life Sciences, Japan
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- Yamamoto Kazuhiro
- Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Japan
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- Takenaka Atsushi
- Department of Urology, Tottori University, Japan
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- Hisatome Ichiro
- Department of Cardiovascular Medicine, Yonago Medical Center, Japan
抄録
<p>Objective Both renal hypouricemia (RHU) and gout are associated with renal dysfunction and urolithiasis. The difference in renal complications associated with RHU and gout, however, has not been studied. We characterized the urate metabolism and complications of patients with RHU and compared them with patients with gout. </p><p>Methods Eighteen patients with RHU who had a serum uric acid (SUA) level <2 mg/dL (10 men and 8 women), 44 patients with gout (44 men) and 16 normouricemic patients (4 men and 12 women) were included. The blood and urinary biochemical data were evaluated. A genetic analysis of uric acid transporter 1 (URAT1) was also conducted in 15 cases with RHU. </p><p>Results The SUA level of RHU was 0.9±0.5/mg/dL, and the Uur/Ucr and Cur/Ccr were 0.56±0.14% and 45.7±18.0%, respectively. A genetic analysis of URAT1 in 15 RHU patients showed that 13 harbored a URAT1 gene mutation, whereas 2 harbored the wild-type gene. The SUA level was significantly lower in RHU patients (n=11) than in either gout patients (n=44) or normouricemic patients (n=16). This reduction was accompanied by the elevation of Cua/Ccr. Urinary beta 2-microglobulin levels were higher in RHU patients than in gout or normouricemia patients. Cua/Ccr correlated with normalized urinary beta 2-microglobulin levels. The prevalence of urolithiasis was 18.2% in RHU cases and 6.8% in gout cases. A homozygous URAT1 mutation was associated with urolithiasis. </p><p>Conclusion Besides urolithiasis, RHU can be associated with tubular dysfunction, such as elevated urinary beta 2-microglobulin levels. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 62 (13), 1915-1920, 2023-07-01
一般社団法人 日本内科学会