Association of serum uric acid level with estimated glomerular filtration rate in diabetic patients

Abstract

Background and Objective: Uric acid may be a novel and important player in the pathogenesis of microvascular complications in diabetes mellitus. The objective of this study was to investigate the association between eGFR and uric acid in patients with type 2 diabetes mellitus. Materials and Methods: A cross-sectional study was done in type 2 diabetic patients of both genders above the age of 18 years. Demographic characteristics collected include age, gender, body weight, height, and duration of diabetes. Laboratory investigations data collected included serum creatinine, blood urea nitrogen, serum uric acid, urine albumin, urine creatinine, urine albumin creatinine ratio, HbA1c, and blood glucose. GFR was calculated using the Modification of Diet in Renal Disease formula (4 variable formula). Results: A total of 63 patients were included in the study. Among them, 35 (55.6%) were males and 28 were females (44.4%). Mean age of the patients was 61.63 ± 10.37 years. Out of 63 patients, 52 had normal uric acid level and 11 patients had elevated uric acid level. eGFR was 81.32 ± 17.53 ml/min in patients with normal uric acid level, whereas it was 61.63 ± 26.18 ml/min in patients with elevated uric acid level. The difference is statistically significant (P = 0.03). Urine albumin creatinine ratio was 12.2 ± 40.92 μg/mg in patients with normal uric acid level and was 47.04 ± 76.58 μg/mg in patients with elevated uric acid level, the difference being statistically significant (P = 0.035). There was a significant negative correlation between uric acid and eGFR (r = -31, P = 0.014), whereas statistically significant correlation was not seen between uric acid level and urine albumin creatinine ratio. Uric acid level was 0.312 ± 0.072 mmol/L in normoalbuminuric patients (55 patients), whereas it was 0.343 ± 0.092 mmol/L in patients with microalbuminuria (8 patients). Conclusion: Serum uric acid is independently and negatively associated with GFR in patients with type 2 diabetes mellitus and thus supporting the concept that uric acid may be involved in the pathogenesis of diabetic nephropathy.