Hyperuricemia Is an Early and Relatively Common Feature in Children with Nephropathy but Its Utility as a Predictor of the Disease Is Limited.

Background: Hyperuricemia is recognized as an important feature of nephropathy, associated with a mutation in the hepatocyte nuclear factor-1B gene, and could serve as a useful marker of the disease. However, neither a causal relationship nor its predictive value have been proven. The purpose of this study was to assess this in children with renal malformations, both with (mut+) and without mutations (mut-).

Methods: We performed a retrospective analysis of clinical characteristics of pediatric patients tested for mutations, collected in a national registry.

Results: 108 children were included in the study, comprising 43 mut+ patients and 65 mut- subjects. Mean sUA was higher and hyperuricemia more prevalent (42.5% vs. 15.4%) in carriers. The two groups were similar with respect to respect to age, sex, anthropometric parameters, hypertension, and renal function. Renal function, fractional excretion of uric acid and parathyroid hormone level were independent predictors of sUA. The potential of hyperuricemia to predict mutation was low, and addition of hyperuricemia to a multivariate logistic regression model did not increase its accuracy.

Conclusions: Hyperuricemia is an early and common feature of nephropathy. A strong association of sUA with renal function and parathyroid hormone limits its utility as a reliable marker to predict mutation among patients with kidney anomalies.