Urinary Uromodulin/Creatinine Ratio as a Potential Clinical Biomarker for Chronic Kidney Disease Patients with Gout: A Pilot Study

Abstract

Objective: Recent studies have reported that reduced excretion of urinary uromodulin is associated with renal tubular function and risks of progressive kidney disease. Gouty nephropathy is usually seen in patients with gout. Patients with chronic gouty nephropathy are characterized by the deposition of monosodium urate crystals primarily involving the collecting ducts in the medulla. We postulated that this correlation may be specific to gout and may serve as a useful biomarker for chronic kidney disease (CKD). Materials and Methods: A total of 114 Taiwanese patients diagnosed with gout (n = 72), CKD (n = 26), or healthy volunteers (n = 16) were prospectively enrolled for this study from the Rheumatology and Nephrology Outpatient Clinics of our institution. We obtained urine and blood samples on patient visits to the outpatient clinics. Demographic data were obtained from medical records. Results: In patients with gout, the spot urinary uromodulin/creatinine ratio (uUMCR; mg/g) in patients with CKD was significantly lower than that in those without CKD (CKD group: 2.2; non-CKD group: 5.6, p = 0.005). Multivariate analysis revealed that patients with CKD and gout had a lower uUMCR than those with gout alone (p = 0.028). A significant association was not observed in our non-gout cohort. Conclusion: The association of decreased uUMCR with CKD status was identified only in patients with gout in the present study. We believe that uUMCR might serve as an indicator of differential CKD in patients with gout.

Diagnostic and prognostic biomarkers for tubulointerstitial fibrosis

“…In contrast, urinary UMOD (uUMOD) levels were decreased in patients with IgAN compared with control subjects, and this was associated with %TIF and eGFR decline (Zhou et al, 2013). Likewise, low levels of uUMOD were observed in patients with chronic gouty nephropathy, in comparison to gout patients without CKD, although the correlation of uUMOD with TIF was not determined in this study (Wu et al, 2019). A very recent study showed a negative correlation between UMOD with percentages of interstitial fibrosis/tubular atrophy (r = −0.31, P < 0.001) in patients with acute interstitial nephritis (Melchinger et al, 2022).…”

Uromodulin — Biological Significance and Prospects for Clinical Use

“…В связи с выполняемыми функциями уромодулина низкий уровень данного белка в моче может быть биомаркером редких генетических аномалий (семейная ювенильная гиперурикемическая нефропатия, медулярная кистозная болезнь почек 2 типа, гломерулокистозная болезнь почек). При гиперурикемической нефропатии у пациентов с подагрой снижение соотношения уромодулин/креатинин в моче было ассоциировано с прогрессированием ХБП [50].…”

Label-Free Protein Detection by Micro-Acoustic Biosensor Coupled with Electrical Field Sorting. Theoretical Study in Urine Models

“…For a long time uromodulin had been rather overlooked by medical professinals but recent researches showed that the levels of uromodulin in plasma and urine are valuable biomarkers of kidney and urinary tract diceases including chronic kidney dicease, urolithiasis, and some genetic disorders [ 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. Various analytical techniques were used for detecting, qualitative determination and characterization of this protein in urine [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ].…”