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Serum Uric Acid as a Predictor for Development of Diabetic Nephropathy in Type 1 Diabetes
- Source :
- Diabetes
- Publication Year :
- 2009
- Publisher :
- American Diabetes Association, 2009.
-
Abstract
- OBJECTIVE Experimental and clinical studies have suggested that uric acid may contribute to the development of hypertension and kidney disease. Whether uric acid has a causal role in the development of diabetic nephropathy is not known. The objective of the present study is to evaluate uric acid as a predictor of persistent micro- and macroalbuminuria. RESEARCH DESIGN AND METHODS This prospective observational follow-up study consisted of an inception cohort of 277 patients followed from onset of type 1 diabetes. Of these, 270 patients had blood samples taken at baseline. In seven cases, uric acid could not be determined; therefore, 263 patients (156 men) were available for analysis. Uric acid was measured 3 years after onset of diabetes and before any patient developed microalbuminuria. RESULTS During a median follow-up of 18.1 years (range 1.0–21.8), 23 of 263 patients developed persistent macroalbuminuria (urinary albumin excretion rate >300 mg/24 h in at least two of three consecutive samples). In patients with uric acid levels in the highest quartile (>249 μmol/l), the cumulative incidence of persistent macroalbumnuria was 22.3% (95% CI 10.3–34.3) compared with 9.5% (3.8–15.2) in patients with uric acid in the three lower quartiles (log-rank test, P = 0.006). In a Cox proportional hazards model with sex and age as fixed covariates, uric acid was associated with subsequent development of persistent macroalbuminuria (hazard ratio 2.37 [95% CI 1.04–5.37] per 100 μmol/l increase in uric acid level; P = 0.04). Adjustment for confounders did not change the estimate significantly. CONCLUSIONS Uric acid level soon after onset of type 1 diabetes is independently associated with risk for later development of diabetic nephropathy.
- Subjects :
- Adult
Male
medicine.medical_specialty
Complications
Time Factors
Adolescent
Endocrinology, Diabetes and Metabolism
Blood Pressure
urologic and male genital diseases
Gastroenterology
Cohort Studies
Diabetic nephropathy
Excretion
Young Adult
chemistry.chemical_compound
Predictive Value of Tests
Risk Factors
Diabetes mellitus
Internal medicine
Internal Medicine
medicine
Albuminuria
Humans
Diabetic Nephropathies
Prospective Studies
Prospective cohort study
Type 1 diabetes
business.industry
Incidence
medicine.disease
Uric Acid
Diabetes Mellitus, Type 1
Endocrinology
chemistry
Uric acid
Original Article
Female
Microalbuminuria
medicine.symptom
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 1939327X and 00121797
- Volume :
- 58
- Database :
- OpenAIRE
- Journal :
- Diabetes
- Accession number :
- edsair.doi.dedup.....7a889f84488c8e9e864d51935f3490fe