Time-averaged serum uric acid and 10-year incident diabetic kidney disease: A prospective study from China

The association between serum uric acid (SUA) and the risk of diabetic kidney diseases (DKD) remains controversial. We aim to investigate the association between time-averaged SUA and long-term incident DKD among general population-based patients with diabetes.

Altogether 1327 patients with diabetes and without kidney disease (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73m² , and without proteinuria) were included. Incident DKD were defined by the occurrence of renal function decline (eGFR<60 mL/min/1.73m² ) and/or macroalbuminuria (urinary albumin-creatinine-ratio ≥ 30 mg/mM creatinine). The associations between baseline and time-averaged SUA and DKD were analyzed.

The mean age was 53.7 ± 8.0. During 10.2 ± 0.4 years' follow-up, 85 (6.4%) patients developed renal function decline and 101 (7.6%) patients developed macroalbuminuria. Compared to those with time-averaged SUA in the second quartile (207-240 μM/L for women, 233-272 μM/L for men), odds ratio (OR) for renal function decline was 1.92 (95% confidence interval [CI], 1.02 to 3.62; P = .04) among those with SUA in the top quartile (women≥285 μM/L; men≥324 μM/L); and OR for macroalbuminuria was 1.86 (95% CI 1.01 to 3.43; P = .05) among those with SUA in the bottom quartile (women ≤207 μM/L; men ≤233 μM/L)). No significant associations were observed between baseline SUA with incident DKD.

Long-term exposure to both high and low SUA level are associated with increased risk of incident DKD among patients with diabetes.