Correlation between serum uric acid and renal dysfunction in type 2 diabetic kidney disease

Objective To investigate the relationship of serum uric acid (UA) and renal dysfunction in hospitalized patients with type 2 diabetic kidney disease (T2DKD) and to assess the value of serum UA in T2DKD prevention and treatment.Methods From January 2009 to August 2011 , serum creatinine , serum UA and 24-hour urinary albumin excretion ( 24h-UAE ) of the hospitalized patients with type 2 diabetes mellitus were dectected in our hospital.Glomerular filtration rate ( eGFR ) was calculated by the modification of diet in renal disease ( MDRD ) equation.When eGFR was less than 60mL·min-1·1.73m-2,the patient was diagnosed as renal dysfunction. Results According to the Clinical Practice Guidelines for Diabetes and Chronic Kidney Disease suggested by National Kidney Foundation ( NFK 2007 ), 364 T2DKD patients were enrolled in the present study.There were 201 males and 163 females with an average age of ( 63±12 ) years.The serum UA level was ( 350±99 ) μ mol / L and eGFR was ( 80±31 ) mL·min-1· 1.73m-2 .The prevalence of renal inadequacy was 26.9% ( 98 / 364 ) .Serum UA level in eGFR60mL·min-1·1.73m-2 patients was significantly higher than that in eGFR≥60mL·min-1·1.73m-2 patients ( P0.01 ) .Univariate correlation analysis demonstrated that serum UA level was negatively correlated with eGFR ( r=-0.303 , P0.05 ) .The prevalence of microalbuminuria and macroalbuminuria was 50.5% ( 184 / 364 ) and 49.5% ( 180 / 364 ), respectively.Serum UA level in macroalbuminuric group wassignificantly higher than that in microalbuminuric group ( P0.01 ) .Univariate correlation analysis demonstrated that serum UA level was positively correlated with 24h-UAE ( r=0.162 , P 0.05 ) .Multivariate Logistic regression analysis indicated that age ( OR=1.116 , 95%CI : 1.065-1.169 , P0.01 ), 24h-UAE ( OR=1.001 , 95%CI : 1.000-1.001 , P0.01 ), and serum UA ( OR=1.006 , 95%CI : 1.001-1.011 , P0.05 ) were independent factors of renal dysfunction in T2DKD patients.Conclusion Reduction of serum UA level and urinary albumin excretion can delay the development of renal lesions in T2DKD patients.