Hyperuricemia and overexcretion of uric acid increase the risk of simple renal cysts in type 2 diabetes

Abstract

Previous studies have discussed the relationship between simple renal cysts (SRC) and serum uric acid level in healthy individuals. We performed a cross-sectional study to evaluate the association between serum uric acid level and fractional excretion of uric acid (FEUA) and simple renal cysts in males and postmenopausal females with type 2 diabetes. The overall prevalence of SRC was 18.1% in our population. SRC prevalence was significantly higher in hyperuricemic than normouricemic subjects (27.3% vs. 16.8%, P < 0.001). Subjects who overexcreted uric acid had a higher prevalence of SRC than underexcretors (total population: 21.6% vs. 16.3%; normouricemic subjects: 19.8% vs. 13.7%; hyperuricemic subjects: 50.0% vs. 22.7%, all P-values < 0.05). Hyperuricemia (odds ratio [OR] 1.824, 95% confidence interval [CI] 1.332-2.498, P < 0.001); FEUA (OR 1.046, 95% CI 1.002-1.091, P < 0.05); male gender (OR 1.922, 95% CI 1.489-2.480, P < 0.001); age (OR 1.049, 95% CI 1.035-1.064, P < 0.001); and albuminuria (OR 1.492, 95% CI 1.176-1.892, P < 0.01) were independent risk factors for SRC development. These findings suggested that hyperuricemia and high level of FEUA were both independent risk factors for SRC development in males and postmenopausal females with type 2 diabetes. Half of overproduction hyperuricemic patients had SRC.Simple renal cysts (SRC) are the most common non-hereditary type of benign renal cysts in adults. The prevalence of SRC varies by population, geographic region, and the imaging modality used. Most SRC are asymptomatic, being accidentally detected by abdominal ultrasonography or computed tomography during a medical check-up or when another medical condition is being evaluated 1 . However, some cysts tend to increase in size and can be sufficiently large to cause pain, hematuria, and/or urinary obstruction 2, 3 . Also, previous studies showed that SRC may be associated with deterioration of renal function [4][5][6] . SRC presence correlated significantly with higher serum creatinine concentrations and reduced estimated creatinine clearances 5 . The prevalence of chronic renal failure in patients with SRC was about 1.5-fold greater than that in those lacking SRC 6 . SRC have also been suggested to be associated with hypertension 7, 8 ; blood pressure normalization was reported after adequate treatment of SRC 9 . In general populations, all of poor renal function, hypertension, age 1, 10 , male gender 1, 10-13 , obesity 14, 15 , smoking 13 , renal stones 12, 13 and serum uric acid level 16,17 are associated with SRC. It is important to identify (and eliminate) risk factors for SRC development. This would reduce the prevalence of the condition and improve patient outcomes.Uric acid is a product of the metabolic breakdown of purine nucleotides and is excreted largely via the kidneys. Any relationship between serum uric acid level and SRC remains controversial. The prevalence of SRC was significantly higher in a gout group than in a sex-and age-matched control group (26.0% vs. 10.6%) 16 . Serum uric acid is ...

The Relationship Between Simple Renal Cysts and Renal Function in Patients With Type 2 Diabetes

“…In addition, Hasegawa et al (2013) reported an increased prevalence of SRCs in patients with gout, indicating that gout might be related to the formation of SRCs. For patients with T2DM, gender, age, hyperuricaemia, proteinuria, and hyperuricaemia excretion score are independent risk factors for renal cysts (Han et al, 2017). However, in addition to these factors, CVD, an increased serum phosphorus level, and reduced renal function were identified to be associated with SRCs in the present study.…”

“…with a study that reported no association between hypertension and SRCs in diabetic patients (Han et al, 2017). In the diabetic population, the relationship between hypertension and SRCs was not significant.…”

“…Based on these data, SRCs are common renal diseases that potentially result in a decrease in renal function. On the other hand, in patients with T2DM, the incidence of SRCs in Chinese males and postmenopausal females is 18.1% (Han et al, 2017). However, the relationship between SRCs and renal function in patients with T2DM remains unclear.…”

Sex Differences in Kidney Stone Disease in Chinese Patients with Type 2 Diabetes Mellitus

“…RC, especially simple RC, are lesions that are usually benign asymptomatic and are frequently observed in adults [20]. RC are more common in males [21] and are associated with hyperuricemia [22], hypertension [15,20], and renal dysfunction [23]. RC share some similar characteristics with KSD, but little is known about their specific relationship.…”

Molecular Imprinting Technology for Determination of Uric Acid

“…Estimations of uric acid values are usually based on the measurements of serum uric acid concentration, uric acid clearance, and 24-h urinary uric acid excretion. A normal uric acid level, urinary concentrations, in the urine varies from 250 to 750 mg per 24 h [ 8 ].…”