Serum uric acid and risk of CKD in type 2 diabetes

Salvatore de Cosmo, Francesca Viazzi, Antonio Pacilli, Carlo Giorda, Antonio Ceriello, Sandro Gentile, Giuseppina Russo, Maria C. Rossi, Antonio Nicolucci, Pietro Guida, Daniel Feig, Richard J. Johnson, Roberto Pontremoli

Research output: Contribution to journalArticlepeer-review

Abstract

Background and objective Serum uric acid may predict the onset and progression of kidney disease, but it is unclear whether uric acid is an independent risk factor for diabetic nephropathy. Our aim was to study the relationship between uric acid levels and the development of CKD components in patients with type 2 diabetes. Design, setting, participants,&measurements Longitudinal study of a cohort of patients with type 2 diabetes from the database of the ItalianAssociation ofClinical Diabetologists network. Froma total of 62,830patients attending the diabetes centers between January 1, 2004, and June 30, 2008,we considered those with baseline eGFR values≥60 ml/min per 1.73m2and normal albumin excretion (n=20,142). Urinaryalbumin excretion, GFR, andserumuric acidwere available in 13,964 patients. We assessed the association of serum uric acid quintiles with onset of CKD components by multinomial logistic regression model adjusting for potential confounders. We calculated the relative risk ratios (RRRs) for eGFR 2, albuminuria, and their combination at 4 years. Results At 4-year follow-up, 1109 (7.9%) patients developed GFR 2with normoalbuminuria, 1968 (14.1%) had albuminuria with eGFR ≥60 ml/min per 1.73 m2, and 286 (2.0%) had albuminuria with eGFR 2. The incidence of eGFR 2increased in parallel with uric acid quintiles: Comparedwith the lowest quintile, RRRswere 1.46 (95% confidence interval [CI], 1.14 to 1.88; P=0.003), 1.44 (95% CI, 1.11 to 1.87; P=0.006), 1.95 (95% CI, 1.48 to 2.58; P2. Conclusions Mild hyperuricemia is strongly associated with the risk of CKD in patients with type 2 diabetes.

Original languageEnglish
Pages (from-to)1921-1929
Number of pages9
JournalClinical Journal of the American Society of Nephrology
Volume10
Issue number11
DOIs
Publication statusPublished - Nov 6 2015

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

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