Can Spot Urinary Uric Acid/Creatinine Ratio Be Used as a Surrogate for Renal Scarring in Vesicoureteric Reflux?

Abstract

Objective: Increased urinary excretion of uric acid has been shown to be associated with vesicoureteral reflux (VUR). The aim of this study is evaluate if urinary uric acid/creatinine ratio can be used as a surrogate for renal scarring in VUR. Method: Retrospective chart analysis was made to identify patients who were diagnosed with VUR. Those with secondary VUR, <3 years of age, and inadequate evaluation were excluded. Age, gender, VUR status, dimercaptosuccinic acid (DMSA) scintigraphy findings, presence of hypertension and microalbuminuria, and body mass index values were noted. Uric acid, calcium and creatinine levels for both urine and serum were measured. Urinary uric acid/creatinine and calcium/creatinine ratios were assessed for age. Backward logistic regression analysis was used for determining any predictors. Results: A total of 76 patients were eligible for the study. Mean age was 8.2±3.7 years. There were 49 females and 27 males. Fifty-one patients had renal scars while 25 had no scars. Microalbuminuria was present in 22 patients. Hypertension was detected in 5 patients. Hyperuricosuria was found in 23 patients (30.7%) while hypercalciuria was found only in 1 patient (1.3%). There was no correlation between urinary uric acid/creatinine and renal scarring, microalbuminuria and hypertension. Also, no correlation was found between urinary calcium/creatinine levels and aforementioned parameters (p values >0.05, for all). Conclusions: Our results indicate that urinary uric acid/creatinine ratio would not be used as surrogate for renal scarring in VUR.