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03.02.2016 | Original Article
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)]
Erschienen in: Diabetology International | Ausgabe 4/2016
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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.