Serum Uric Acid Levels and Risk of Rapid Decline of Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes: Findings from a 5-Year Prospective Cohort Study

Le, Hoa Tuyet; Le, Tung Thanh; Tran, Nguyet Minh Thi; Nguyen, Thuy Thanh Thi; Minh, Ni Chanh Su; Le, Quyen Thi; Tram, Tuyet Anh Thi; Tran, Thang Duc; Doan, Tung Xuan; Duong, Mai; Thai, Truc Thanh

doi:10.3390/healthcare9101341

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…Moreover, several studies have identified SUA as a risk factor for the development of kidney disease in specific populations such as diabetic, non-diabetic, hypertensive, and non-hypertensive populations. 11,[30][31][32][33][34] Given that hyperuricemia can interact with other risk factors, such as metabolic syndrome, diabetes, and hypertension, to accelerate the progression of declining renal function, 33,[35][36][37] prompt identification of high-risk patients is crucial to reduce the burden of CKD. Furthermore, our study revealed a non-linear relationship between SUA levels and the risk of CKD.…”

Section: Discussionmentioning

confidence: 99%

Serum Uric Acid Levels and Their Association with Renal Function Decline and Kidney Disease Progression in Middle-Aged and Elderly Populations: A Retrospective Cohort Study

Luo,

Wu,

Meng

et al. 2023

JMDH

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Objective To evaluate the associations between serum uric acid (SUA) levels and estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD), with a focus on gender differences, and variations among women pre-and post-menopausal stages. Design A retrospective cohort study. Setting A large community-based survey was conducted every two years from 2010 to 2018 in Hangzhou, Zhejiang Province, Southeastern China. Participants 10,218 participants (40 years or above) without CKD at baseline who underwent three physical examinations were enrolled. CKD was defined as an eGFR of less than 60 mL/min/1.73m 2 . Methods Participants with SUA levels were divided into four groups (Q1-Q4) based on baseline SUA quartiles. The Q1 was the reference. By stratifying participants by gender, the relationships between SUA levels and eGFR were investigated using the generalized additive mixture model. The associations of SUA and the risk of incident CKD were examined using multivariate logistic regression models in the generalized estimating equation. Results After adjusting for confounding variables, a nonlinear association between SUA and eGFR was observed in females, while an approximately linear relationship was observed in males, suggesting that elevated SUA levels are associated with renal function decline. Furthermore, the highest quartile of SUA was associated with a 2.16-fold (95% CI: 1.31–3.58) increased risk of CKD in males and a 2.76-fold (95% CI: 1.59–4.78) increased risk in females, compared with the lowest quartile. And the spline curves demonstrated a U-shaped pattern, suggesting a potential threshold effect of SUA on the risk of CKD. Additionally, Subgroup analyses revealed significant associations between elevated SUA levels with CKD in postmenopausal women, but not in premenopausal women. Conclusion Elevated SUA levels are associated with an increased risk of CKD development and renal function decline in middle-aged and elderly individuals, particularly in postmenopausal women.

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Section: Discussionmentioning

confidence: 99%

Serum Uric Acid Levels and Their Association with Renal Function Decline and Kidney Disease Progression in Middle-Aged and Elderly Populations: A Retrospective Cohort Study

Luo,

Wu,

Meng

et al. 2023

JMDH

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“…The inclusion criteria were (1) age ≥ 20 years old and (2) permanent residents of Urumqi (≥ 6 months). The exclusion criteria were (1) patients with incomplete demographic data and clinical data; (2) patients with severe liver or kidney disease and those who were administered drugs that affect blood creatinine and uric acid, and those who underwent any form of kidney replacement therapy; (3) patients with eGFR < 60 mL/min·(1.73 m 2 ) [ 20 ],…”

Section: Methodsmentioning

confidence: 99%

Correlation between the increase in serum uric acid and the rapid decline in kidney function in adults with normal kidney function: a retrospective study in Urumqi, China

Yang

et al. 2023

BMC Nephrol

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Background To examine the association between elevated serum uric acid (SUA) levels and the rapid decline in kidney function by conducting a retrospective cohort study on a physically healthy population in Urumqi, China. Methods A cohort study of 2,802 physically healthy people with a normal estimated glomerular filtration rate (eGFR) was investigated from 2018 to 2021. The examination procedure included using questionnaires, taking physical measurements, and blood sampling. The rapid decline in kidney function was defined as eGFR > 5 mL·min–1 ·(1.73 m2 )–1 year. The relationship between elevated SUA levels and the rapid decline in kidney function was assessed. Results When performing the three-year retrospective analysis, 688 (28.55%) cases experienced a rapid decline in kidney function, and 52 (1.9%) cases developed chronic kidney disease (CKD). They were divided into the stable group and the rapidly declining kidney function group according to eGFR > 15 mL·min–1·(1.73 m2 )–1. The comparison revealed a greater increase in uric acid in the rapidly declining kidney function group [0.30 (-0.29, 0.82) mg/dL vs. − 0.07(-0.54, 0.37) mg/dL, Z = − 8.822, P < 0.001]. The participants were further divided into four groups according to their uric acid levels in 2018 and 2021, which included the normal to normal (N-N) group, the normal to hyperuricemia (HUA) (N-H) group, the HUA to normal (H-N) group, and the persistently HUA (H-H) group. The decrease in eGFR was significantly higher in the N-H group than in the other three groups (χ2 = 20.580, P < 0.001). The results of the multifactorial logistic regression analysis showed that elevated uric acid was a risk factor for the rapid decline in kidney function (OR = 1.640, P < 0.001). Conclusion Elevated SUA levels were a risk factor for the rapid decline in kidney function in the Chinese health examination population. Higher SUA levels might predict the occurrence of progressive kidney impairment.

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“…Type 2 diabetes mellitus (T2DM) is characterized by chronic hyperglycemia, insulin resistance and usually along with lipid disorder [3], and hyperuricemia [4]. Increased serum uric acid (SUA) is associated with diabetes [5] and several diabetic complications [6][7][8][9][10][11][12] including diabetic peripheral neuropathy (DPN). Indeed, hyperuricemia is common in patients with T2DM and associated with the C-peptide incremental effect of islet beta cell function in T2DM, especially in female patients [13].…”

Section: Introductionmentioning

confidence: 99%

Serum Uric Acid Levels Are Related to Diabetic Peripheral Neuropathy, Especially for Motor Conduction Velocity of Tibial Nerve in Type 2 Diabetes Mellitus Patients

Zhang

Vladmir

Zhang

et al. 2023

Journal of Diabetes Research

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Background. Oxidative stress is one of the most critical factors that contribute to the pathogenesis of neuronal damage, including diabetic peripheral neuropathy (DPN). Uric acid is a kind of natural antioxidant that plays a major role in the antioxidant capacity against oxidative stress. Here, we aim to determine the role of serum uric acid (SUA) in the DPN of patients with type 2 diabetes mellitus (T2DM). Patients and Methods. 106 patients with T2DM were recruited and divided into the DPN group and the control group. Clinical parameters, especially for motor nerve fiber conduction velocity and sensory nerve fiber conduction velocity, were collected. Differences between T2DM patients with and without DPN were compared. Correlation and regression analyses were performed to explore the association between SUA and DPN. Results. Compare with 57 patients with DPN, 49 patients without DPN showed lower HbA1c and elevated SUA levels. Additionally, SUA levels are negatively associated with the motor conduction velocity of tibial nerve with or without adjusting for HbA1c. Besides, it is suggested that decreased SUA levels may influence the motor conduction speed of the tibial nerve by multiple linear regression analysis. Moreover, we demonstrated that decreased SUA level is a risk factor for DPN in patients with T2DM by binary logistic regression analysis. Conclusion. Lower SUA is a risk factor for DPN in patients with T2DM. Additionally, decreased SUA may influence the damage of peripheral neuropathy, especially for motor conduction velocity of the tibial nerve.

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Serum Uric Acid Levels and Risk of Rapid Decline of Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes: Findings from a 5-Year Prospective Cohort Study

Cited by 7 publications

References 25 publications

Serum Uric Acid Levels and Their Association with Renal Function Decline and Kidney Disease Progression in Middle-Aged and Elderly Populations: A Retrospective Cohort Study

Serum Uric Acid Levels and Their Association with Renal Function Decline and Kidney Disease Progression in Middle-Aged and Elderly Populations: A Retrospective Cohort Study

Correlation between the increase in serum uric acid and the rapid decline in kidney function in adults with normal kidney function: a retrospective study in Urumqi, China

Serum Uric Acid Levels Are Related to Diabetic Peripheral Neuropathy, Especially for Motor Conduction Velocity of Tibial Nerve in Type 2 Diabetes Mellitus Patients

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