# Association between serum uric acid and urinary uric acid excretion indicators and early impaired kidney function in newly diagnosed T2DM patients with normal serum uric acid levels: a retrospective study

## TL;DR

This study finds that even normal uric acid levels in new type 2 diabetes patients can indicate early kidney issues when combined with other uric acid measures.

## Contribution

Identifies uric acid excretion indicators as potential predictors of early kidney dysfunction in T2DM patients with normal serum uric acid.

## Key findings

- Higher fractional excretion of uric acid (FEur) and estimated uric acid glomerular filtration (EurGF) are linked to early impaired kidney function.
- Combining serum uric acid (SUA) with FEur improves detection of early kidney dysfunction risk.
- Age and systolic blood pressure are also significant factors associated with early kidney dysfunction in T2DM patients.

## Abstract

To analyze the association between serum uric acid (SUA), urinary uric acid excretion indicators and early impaired kidney function (EIKF) in newly diagnosed type 2 diabetes (T2DM) patients with normal SUA levels, and to analyze their potential value in predicting the risk of EIKF.

A cross-sectional study was conducted in 628 patients with newly diagnosed T2DM who were admitted to ward of endocrinology department. According to the renal function, patients were divided into non-EIKF group (estimated glomerular filtration rate (eGFR) ≥ 90 ml/min/1.73 m2 and urinary albumin-to-creatinine ratio (UACR) < 30 mg/g) and EIKF group (eGFR < 90 ml/min/1.73 m2 and (or) UACR ≥ 30 mg/g). Anthropometric, clinical, and biochemical data were collected. Regression analysis was conducted to investigate the associated factors of EIKF. Receiver operating characteristic (ROC) were constructed to assess the potential detective value of the uric acid variables on EIKF risk.

Compared with non-EIKF group, patients in EIKF group were older and had a higher proportion of hypertension. Systolic blood pressure (SBP), HOMA-β, HOMA-IR, SUA, UACR, fractional excretion of uric acid (FEur), and estimated uric acid glomerular filtration (EurGF) levels were higher, while urinary uric acid (Uur), uric acid clearance (Cur) and glomerular filtration load of uric acid (FLur) levels were lower in patients with EIKF. Multivariate logistic regression analysis showed that age, SBP and EurGF were associated with the prevalence of EIKF. The ROC curve analyses revealed high areas under the curves of EurGF or the combination of SUA and FEur for detecting EIKF.

For newly diagnosed T2DM patients, even SUA levels are in the normal range, higher SUA, FEur and EurGF are associated with EIKF.