Association between serum uric acid and renal outcome in patients with biopsy-confirmed diabetic nephropathy

Abstract

Objective: To investigate the relationship between serum uric acid (SUA) level and renal outcome in patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy(DN). Methods: A total of 393 Chinese patients with T2DM and biopsy-proven DN and followed at least one year were enrolled in this study. Patients were stratified by the quartiles of baseline level of SUA: Q1 group286.02± 46.66 μmol/L (n=98); Q2 group: 358.23±14.03μmol/L (n=99); Q3 group: 405.50±14.59μmol/L (n=98) and Q4 group: 499.14±56.97μmol/L (n=98).Renal outcome was defined by progression to end stage renal disease (ESRD). Kaplan-Meier survival analysis and Cox proportional hazards model were used to analyze the association between SUA quartiles and the renal outcomes. Results: During the median 3-year follow-up period, there were 173 ESRD outcome events (44.02%) during follow-up. No significant difference among SUA level the risk of progression of DN (P=0.747) was shown in the Kaplan-Meier survival analysis. In multivariable-adjusted model, HRs for developing ESRD were 1.364(0.621-2.992; p=0.439), 1.518(0.768-3.002; p=0.230) and 1.411(0.706-2.821; p=0.330) for the Q2, Q3 and Q4, respectively, in comparison with the Q1 (P=0.652). Conclusions: No significant association between SUA level and renal outcome of ESRD in Chinese patients with T2DM and DN was found in our study. Besides, the role of uric acid-lowering therapy in delaying DN progression and improve ESRD outcome had not yet been proven. Further study was needed to clarify the renal benefit of the uric acid-lowering therapy in the treatment of DN.

Association between hyperuricemia and diabetic nephropathy: insights from the national health and nutrition examination survey 2007–2016 and mendelian randomization analysis

“…In one study, 393 patients with DN confirmed by biopsy were included. During the one-year follow-up, no significant correlation was found between the high SUA levels and the renal outcomes of Chinese diabetes patients and DN patients with end-stage renal disease [29]. Furthermore, the role of SUA lowering therapy in delaying DN progression and improving ESRD prognosis has not been confirmed.…”