Serum uric acid to creatinine ratio: A predictor of incident chronic kidney disease in type 2 diabetes mellitus patients with preserved kidney function.
Serum uric acid has shown to be a predictor of renal disease progression in most but not all studies. This study aims to test whether renal function-normalized serum uric acid is superior to serum uric acid as the predictor of incident chronic kidney disease in type 2 diabetes mellitus patients.



In this study, 1339 type 2 diabetes mellitus patients with estimated glomerular filtration rate ⩾60 mL/min/1.73 m2and normouricemia were included. Renal function-normalized serum uric acid was calculated using serum uric acid/creatinine. Cox regression analysis was used to estimate the association between serum uric acid, renal function-normalized serum uric acid and incident chronic kidney disease.



In total, 74 (5.53%) patients developed to chronic kidney disease 3 or greater during a median follow-up of 4 years, with older ages, longer diabetes duration and lower estimated glomerular filtration rate at baseline. The decline rate of estimated glomerular filtration rate was positively correlated with serum uric acid/creatinine ( r = 0.219, p < 0.001), but not serum uric acid ( r = 0.005, p = 0.858). Moreover, multivariate analysis revealed that serum uric acid was not an independent risk factor for incident chronic kidney disease ( p = 0.055), whereas serum uric acid to creatinine ratio was significantly associated with incident chronic kidney disease independently of potential confounders including baseline estimated glomerular filtration rate.



serum uric acid to creatinine ratio might be a better predictor of incident chronic kidney disease in type 2 diabetes mellitus patients.
1 Center for Diabetes Care, Education and Research, Jiangsu Province Institute of Geriatrics, Nanjing, China.|2 Department of Endocrinology and Metabolism, Jiangsu Province Official Hospital, Nanjing, China.
Liubao
L
Gu
3 Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Liji
L
Huang
1 Center for Diabetes Care, Education and Research, Jiangsu Province Institute of Geriatrics, Nanjing, China.
Haidi
H
Wu
1 Center for Diabetes Care, Education and Research, Jiangsu Province Institute of Geriatrics, Nanjing, China.|2 Department of Endocrinology and Metabolism, Jiangsu Province Official Hospital, Nanjing, China.
Qinglin
Q
Lou
1 Center for Diabetes Care, Education and Research, Jiangsu Province Institute of Geriatrics, Nanjing, China.|2 Department of Endocrinology and Metabolism, Jiangsu Province Official Hospital, Nanjing, China.
Rongwen
R
Bian
D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003404:Creatinine / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
D015415:Biomarkers; D014527:Uric Acid; D003404:Creatinine
Type 2 diabetes mellitus; chronic kidney disease; risk factor; serum uric acid