Characterization of Urate Metabolism and Complications of Patients with Renal Hypouricemia

  • Miyazaki Satoshi
    Division of Cardiology, Fujii Masao Memorial Hospital, Japan
  • Hamada Toshihiro
    Department of Community-based Family Medicine, Faculty of Medicine, Tottori University, Japan
  • Isoyama Tadahiro
    Department of Urology, Yonago Medical Center, Japan
  • Okada Shinichi
    Department of Pediatrics, Yonago Medical Center, Japan
  • Tomita Katsuyuki
    Department of Respiratory Disease, Yonago Medical Center, Japan
  • Endo Yusuke
    Advanced Medicine, Innovation and Clinical Research Center, Tottori University Hospital, Japan
  • Kuwabara Masanari
    Department of Cardiology, Toranomon Hospital, Japan
  • Sugihara Shinobu
    Department of Health Service Center, Shimane University, Japan
  • Ogino Kazuhide
    Department of Cardiology, Tottori Red Cross Hospital, Japan
  • Ninomiya Haruaki
    Department of Biological Regulation, Faculty of Medicine, Tottori University, Japan
  • Ichida Kimiyoshi
    Department of Pathophysiology, Tokyo University of Pharmacy and Life Sciences, Japan
  • Yamamoto Kazuhiro
    Division of Cardiovascular Medicine, Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University, Japan
  • Takenaka Atsushi
    Department of Urology, Tottori University, Japan
  • 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

  • Internal Medicine

    Internal Medicine 62 (13), 1915-1920, 2023-07-01

    一般社団法人 日本内科学会

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