Study On The Relationship Between Serum High Uric Acid Levels In Diabetic Patients And The Occurrence And Progression Of Diabetic Nephropathy

Objective Diabetic kidney disease(DKD)is one of the severe microvascular complications in diabetic patients and the main cause of end-stage renal disease.DKD can also increases the cardiovascular mortality of diabetic patients.Albuminuria is the characteristic clinical manifestation of DKD.The present study is to explore the risk factors for short-term progression of albuminuria in patients with type 2 diabetes(T2DM).Methods The retrospective cohort study design was performed to consecutively recruit 210 hospitalized T2 DM patients who met the inclusion criteria,including 102 males and 108 females from April 2010 to April 2015.The data of the patients two times in hospital(as baseline and follow-up information,respectively),including general data,biochemical examinations and medication were collected.experimental design 1.Comparison of baseline clinical data of patients with T2 DM 2.Analysis of uric acid level and clinical characteristics of proteinuria progression group and non-progression group 3.Analysis of risk factors of baseline proteinuria 4.Multivariate Logistic analysis was used to explore the potential risk factors for baseline albuminuria and short-term progression of albuminuria.Results Serum uric acid levels were significantly higher in the patients with macroalbuminuria(≥ 300 mg/24 h)than those in the patients without albuminuria(< 30 mg/24 h)at baseline(5.58 vs 4.67 mg/dL,P=0.002).At the second hospitalization of 207 patients(excluding 3 samples with missing data),51 patients(24.6%)had progress in albuminuria and 156 patients(75.4%)had no progress.Serum uric acid levels were significantly higher in the progression group than those in the non-progression group(P=0.009).Hypertension,fasting blood glucose,and serum uric acid levels are risk factors for albuminuria,while the use of the hypoglycemic agent metformin is a protective factor for albuminuria.Multivariate Logistic regression analysis showed that high serum uric acid level was an independent risk factor for progression of albuminuria in T2 DM patients(OR=1.349,95%CI 1.014-1.793,P=0.040).Conclusion ·The high serum uric acid level may be an independent risk factor for short-term progression of albuminuria,and early intervention with hyperuricemia might delay the progression of diabetic kidney disease in T2 DM patients.