Genotype and Phenotype of Renal Hypouricemia: A Single-Center Study from China

Mol Diagn Ther. 2024 Jan;28(1):87-99. doi: 10.1007/s40291-023-00683-w. Epub 2023 Nov 16.

Abstract

Background: Renal hypouricemia (RHUC), a rare inherited disorder characterized by impaired uric acid reabsorption and subsequent profound hypouricemia, occurs mainly due to variants in SLC22A12 or SLC2A9. Only anecdotal cases and one small-scale RHUC screening study have been reported in the Chinese population.

Methods: A total of 19 patients with RHUC from 17 unrelated families were recruited from our center. The medical history, clinical manifestations, biochemical exam, and clinical outcomes were collected. Next-generation sequencing-based targeted gene sequencing or whole exon sequencing was performed.

Results: A total of 22 variants in SLC22A12 or SLC2A9 were found in 19 patients. The variant c.944G>A (p.W315X) in SLC2A9 was identified in three patients. Three variants c.165C>A (p.D55E), c.1549_1555delGAGACCC (p.E517Rfs*17), and c.1483T>C (p.W495R) in SLC22A12 and three variants c.1215+1G>A (splicing variant), c.643A>C (p.T215P), and c.227C>A (p.S76X) in SLC2A9 were novel. A proportion of 10 out of 19 patients presented with exercise-induced acute kidney injury (EIAKI). The renal outcome was favorable. Five patients had nephrolithiasis, in whom three had hypercalciuria.

Conclusion: The current study reported six novel variants in SLC22A12 and SLC2A9 genes of Chinese patients with RHUC. The variant c.944G>A (p.W315X) in SLC2A9 may be common in Chinese patients. EIAKI is the main clinical phenotype associated with RHUC in our cohort, with a favorable outcome. Hypercalciuria presented in some RHUC patients is a new finding.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury*
  • China
  • Genotype
  • Glucose Transport Proteins, Facilitative / genetics
  • Humans
  • Hypercalciuria
  • Organic Anion Transporters* / genetics
  • Organic Cation Transport Proteins / genetics
  • Phenotype
  • Renal Tubular Transport, Inborn Errors*
  • Urinary Calculi*

Substances

  • Glucose Transport Proteins, Facilitative
  • Organic Anion Transporters
  • Organic Cation Transport Proteins
  • SLC22A12 protein, human
  • SLC2A9 protein, human

Supplementary concepts

  • Renal hypouricemia