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. 2016 Feb 3;7(4):352-360.
doi: 10.1007/s13340-016-0254-2. eCollection 2016 Dec.

Serum uric acid levels are associated with a high risk of rapid chronic kidney disease progression among patients with type 2 diabetes: a prospective cohort study [Diabetes Distress and Care Registry at Tenri (DDCRT 12)]

Hirohito Kuwata  1 , Shintaro Okamura  1 , Yasuaki Hayashino  1 , Hitoshi Ishii  2 , Satoru Tsujii  1
Affiliations

Serum uric acid levels are associated with a high risk of rapid chronic kidney disease progression among patients with type 2 diabetes: a prospective cohort study [Diabetes Distress and Care Registry at Tenri (DDCRT 12)]

Hirohito Kuwata et al. Diabetol Int. .

Abstract

Background: We assessed the prospective association between baseline serum uric acid (SUA) concentrations and consequent risk of chronic kidney disease (CKD) progression in type 2 diabetes patients.

Methods: Longitudinal data from a Japanese diabetes registry including 3454 type 2 diabetes patients were obtained. To assess the independent correlations between SUA and rapid CKD progression [i.e., 30 % reduction in estimated glomerular filtration rate (eGFR) over 2 years], participants were divided into five groups based on SUA levels: <5.0, ≥5.0-6.0, ≥6.0-7.0, ≥7.0-8.0, and ≥8.0 mg/dl. Cox proportional hazards model adjusted for potential confounders was used for analysis.

Results: After 2 years, rapid CKD progression was recognized in 169 patients (4.89 %) who showed longer duration of type 2 diabetes (15.5 vs. 13.5 years, p = 0.005); higher systolic blood pressure (142.0 vs. 138.3 mmHg, p = 0.016), SUA (6.15 vs. 5.32 mg/dl, p < 0.001), and urinary albumin-creatinine ratio (1127.4 vs. 184.7 mg/gCr, p < 0.001); and lower diastolic blood pressure (69.7 vs. 72.8 mmHg, p = 0.003). Multivariate ratios for rapid CKD progression were 1.19 (p = 0.371), 1.02 (p = 0.937), 1.18 (p = 0.625), and 3.04 (p = 0.004), respectively, for the first, third, fourth, and fifth serum UA range groups; a second group was used as a reference.

Conclusions: Higher SUA levels, independent of possible confounders, were associated with rapid eGFR decline and CKD progression in type 2 diabetes patients. SUA may be a useful biomarker for predicting future risk of rapid diabetic CKD progression.

Keywords: Chronic kidney disease; Cohort; Epidemiology; Human; Type 2 diabetes; Uric acid.

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Conflict of interest statement

This study was partially supported by the Manpei Suzuki Diabetes Foundation and JSPS KAKENHI (grant no. 25460641); however, they played no role in the design, conduct, data collection, analysis, or results interpretation of the study or in the preparation, review, or approval of the manuscript. H. Ishii reports personal fees from Takeda Pharmaceutical Co., Ltd., personal fees from Eli Lilly Japan K.K., personal fees from Merck & Co., Inc., personal fees from Astellas Pharma Inc., and personal fees from Novo Nordisk Pharma Ltd., outside the submitted work.All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or a substitute for it was obtained from all patients for being included in the study.

Figures

Fig. 1
Fig. 1
A flow chart to describe inclusion patients
See this image and copyright information in PMC

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