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

Abstract Background 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. Methods Altogether 1327 patients with diabetes and without kidney disease (estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73m 2 , and without proteinuria) were included. Incident DKD were defined by the occurrence of renal function decline (eGFR<60 mL/min/1.73m 2 ) and/or macroalbuminuria (urinary albumin‐creatinine‐ratio ≥ 30 mg/mM creatinine). The associations between baseline and time‐averaged SUA and DKD were analyzed. Results 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. Conclusions Long‐term exposure to both high and low SUA level are associated with increased risk of incident DKD among patients with diabetes.