Hosoya T, Ichida K, Tabe A, Sakai O
Second Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
Nihon Jinzo Gakkai Shi. 1993 Jan;35(1):43-8.
It has been found that polycystic kidney (ADPKD) is often associated with gout. On the other hand, there are reports describing that the hyperuricemia (HU) seen in ADPKD corresponds to a reduction in renal function. We investigated the uric acid metabolism in 44 patients with ADPKD (age, 50 +/- 12.8 years; CCR, 50.5 +/- 41.1 ml/min) at our hospital. From among these 44 patients, 14 with a CCR of 80 ml/min were selected. Their data for uric acid metabolism were compared against those from the previous year's studies on various disease types (114 normal subjects, 70 with membranous nephropathy, 175 with IgA nephritis, 122 with gout, 137 with asymptomatic hyperuricemia, and 42 with diabetes mellitus). Among the 44 patients with ADPKD, the serum uric acid (SUA) was 7.7 +/- 1.9 mg/dl and HU affected 28 (63.6%). The incidence of gouty arthritis was also high (6 patients, 13.6%), revealing a positive correlation between SUA and CCR. Compared with membranous nephropathy and IgA nephritis, ADPKD exhibited an accentuated increase in SUA associated with a reduction in CCR. It is believed that this represents a factor for a high incidence of complications of hyperuricemia and gouty arthritis in ADPKD in contrast to other diseases. However, no increase in the production of uric acid was noted in ADPKD.
已发现多囊肾（常染色体显性遗传性多囊肾病，ADPKD）常与痛风相关。另一方面，有报告称ADPKD患者出现的高尿酸血症（HU）与肾功能减退相对应。我们对我院44例ADPKD患者（年龄50±12.8岁；肌酐清除率，CCR，50.5±41.1 ml/分钟）的尿酸代谢情况进行了研究。在这44例患者中，选取了14例CCR≥80 ml/分钟的患者。将他们的尿酸代谢数据与上一年关于各种疾病类型的研究数据（114例正常受试者、70例膜性肾病患者、175例IgA肾病患者、122例痛风患者、137例无症状高尿酸血症患者和42例糖尿病患者）进行比较。在44例ADPKD患者中，血清尿酸（SUA）为7.7±1.9 mg/dl，28例（63.6%）患者存在高尿酸血症。痛风性关节炎的发病率也较高（6例患者，13.6%），显示SUA与CCR之间呈正相关。与膜性肾病和IgA肾病相比，ADPKD患者的SUA升高更为明显，且与CCR降低相关。据信，与其他疾病相比，这是ADPKD患者高尿酸血症和痛风性关节炎并发症发生率较高的一个因素。然而，未发现ADPKD患者尿酸生成增加。
