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. 2017 Apr 27;12(4):e0176055.
doi: 10.1371/journal.pone.0176055. eCollection 2017.

Prevalence and complications of hypouricemia in a general population: A large-scale cross-sectional study in Japan

Masanari Kuwabara  1   2   3 , Koichiro Niwa  3 , Akira Ohtahara  4 , Toshihiro Hamada  5 , Satoshi Miyazaki  6 , Einosuke Mizuta  4 , Kazuhide Ogino  7 , Ichiro Hisatome  8
Affiliations

Prevalence and complications of hypouricemia in a general population: A large-scale cross-sectional study in Japan

Masanari Kuwabara et al. PLoS One. .

Abstract

Backgrounds: Hypouricemia was reported as a risk factor for exercise-induced acute renal injury (EIAKI) and urinary stones. However, the prevalence of kidney diseases among hypouricemic subjects has not been evaluated. This study was conducted to clarify the prevalence of hypouricemia and the association of hypouricemia with kidney diseases by using a large-scale Japanese population data.

Methods: This study is a retrospective cross-sectional study at the Center for Preventive Medicine, St. Luke's International Hospital, Tokyo, Japan, and Sanin Rousai Hospital, Yonago, Japan. We analyzed the medical records of 90,143 Japanese subjects at the center in St. Luke's International Hospital, Tokyo, and 4,837 subjects in Sanin Rousai Hospital, Yonago, who underwent annual regular health check-up between January 2004 and June 2010. We defined hypouricemia as serum uric acid level of ≤2.0 mg/dL. We checked the medical history of all the study subjects and compared the rates of complications including urinary stones and kidney diseases among those with or without hypouricemia.

Results: The prevalence of hypouricemia was 0.19% in St. Luke's International Hospital, Tokyo, and 0.58% in Sanin Rousai Hospital, Yonago. The prevalence of hypouricemia in women was larger than that in men both in Tokyo (0.31% vs 0.068%, p<0.001) and in Yonago (1.237% vs 0.318%, p<0.001). Among 172 hypouricemic subjects (30 men), the rates of previous urinary stones and kidney diseases (including nephritis/nephrosis) were 1.2% (3.3% men, 0.7% women) and 2.3% (10% men, 0.7% women), respectively. Hypouricemic men had a 9-fold higher rate of previously having kidney diseases compared to non-hypouricemic men (p<0.001). However, the rates of other diseases including urinary stones were not significantly different between the two groups.

Conclusions: Hypouricemia was associated with a history of kidney disease especially in men.

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Conflict of interest statement

Competing Interests: Dr. Kuwabara receives the grant for studying abroad from Federation of National Public Service Personnel Mutual Aid Association in Japan. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Prevalence of hypouricemia (serum uric acid level of ≤2.0 mg/dL).
The prevalence of hypouricemia in Yonago (Japan Sea side) is significantly higher than that in Tokyo (Pacific side) (0.579% vs 0.191%, p<0.001). The prevalence of hypouricemia in women was larger than that in men both in Tokyo (0.310% vs 0.068%, p<0.001) and in Yonago (1.237% vs 0.318%, p<0.001).
Fig 2
Fig 2. The distribution of hypouricemia among serum uric acid level by sex.
The number of the women subjects whose serum uric acid of 2.0 mg/dL was 47. The number of the total (men and women) subjects whose serum uric acid of 2.0 mg/dL was 49. These numbers were above this graph limit (25 subjects), and we showed the numbers in the graph.
Fig 3
Fig 3. The distribution of hypouricemia among each age by sex.
In women, the number of hypouricemia subjects was decreased with age.
See this image and copyright information in PMC

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