Serum uric acid levels and decreased estimated glomerular filtration rate in patients with type 2 diabetes: A cohort study and meta‐analysis

Background

Epidemiological studies suggest that elevated serum uric acid (SUA) is associated with heightened incident kidney disease in both the general population and the type 2 diabetes (T2D) cases, although the results were not entirely consistent.

Methods

We investigated prospective association between SUA levels and estimated glomerular filtration (eGFR) decline risk (eGFR <60 mL min^–1 1.73 m^–2) among 3123 T2D in the Dongfeng‐Tongji cohort and further examined this association with a meta‐analysis. Generalize linear model was used to assess the associations of SUA with eGFR decline in the cohort. In the meta‐analysis, we used both fix‐effects and random‐effects models to calculate the overall effect estimate.

Results

During 5‐year follow‐up, 303 (9.7%) patients developed eGFR decline. After multiple adjustments, the relative risk (RR) (95% CI) of eGFR decline was 1.55 (1.07, 2.26) when comparing the highest with the lowest sex‐specific uric acid quartile. A 100 μmol/L increment of SUA level was significantly associated with 21% increased risk of eGFR decline. The SUA‐eGFR decline association was more evident in men, but not in women. In meta‐analysis, the pooled RR (95% CI) was 2.33 (1.66, 3.25) for developing eGFR decline when comparing the highest with the lowest levels of uric acid. A 100 μmol/L increment of SUA level was significantly associated with a 33% increased risk of eGFR decline.

Conclusions

Our results indicate an independent and significant positive association between higher SUA and increased risk of developing eGFR decline among T2D cases.