Notably, abundant evidence has confirmed hyperuricemia, featured with an increase in serum uric acid, mediates renal impairment via a variety of mechanisms, which include oxidative stress, nitric oxide pathway alteration, insulin resistance (IR), fructose metabolism disorder, inflammatory activation, stimulation of the renin-angiotensin system, and endothelial dysfunction 6, 22, 23. This evidence concerns the gene REN and endothelial dysfunction.