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Ficociello, Linda H.; Rosolowsky, Elizabeth T.; Niewczas, Monika A.; Maselli, Nicholas J.; Weinberg, Janice M.; Aschengrau, Ann; Eckfeldt, John H.; Stanton, Robert C.; Galecki, Andrzej T.; Doria, Alessandro; Warram, James H.; Krolewski, Andrzej S.

High-Normal Serum Uric Acid Increases Risk of Early Progressive Renal Function Loss in Type 1 Diabetes

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  • Medientyp: E-Artikel
  • Titel: High-Normal Serum Uric Acid Increases Risk of Early Progressive Renal Function Loss in Type 1 Diabetes
  • Beteiligte: Ficociello, Linda H.; Rosolowsky, Elizabeth T.; Niewczas, Monika A.; Maselli, Nicholas J.; Weinberg, Janice M.; Aschengrau, Ann; Eckfeldt, John H.; Stanton, Robert C.; Galecki, Andrzej T.; Doria, Alessandro; Warram, James H.; Krolewski, Andrzej S.
  • Erschienen: American Diabetes Association, 2010
  • Erschienen in: Diabetes Care
  • Sprache: Englisch
  • DOI: 10.2337/dc10-0227
  • ISSN: 0149-5992; 1935-5548
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>We previously described a cross-sectional association between serum uric acid and reduced glomerular filtration rate (GFR) in nonproteinuric patients with type 1 diabetes. Here, we prospectively investigated whether baseline uric acid impacts the risk of early progressive renal function loss (early GFR loss) in these patients.</jats:p> </jats:sec> <jats:sec> <jats:title>RESEARCH DESIGN AND METHODS</jats:title> <jats:p>Patients with elevated urinary albumin excretion (n = 355) were followed for 4–6 years for changes in urinary albumin excretion and GFR. The changes were estimated by multiple determinations of albumin-to-creatinine ratios (ACRs) and serum cystatin C (GFRcystatin).</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>At baseline, the medians (25th–75th percentiles) for uric acid, ACR, and GFRcystatin values were 4.6 mg/dl (3.8–5.4), 26.2 mg/g (15.1–56.0), and 129 ml/min per 1.73 m2 (111–145), respectively. During the 6-year follow-up, significant association (P &amp;lt; 0.0002) was observed between serum uric acid and development of early GFR loss, defined as GFRcystatin decline exceeding 3.3% per year. In baseline uric acid concentration categories (in mg/dl: &amp;lt;3.0, 3.0–3.9, 4.0–4.9, 5.0–5.9, and ≥6), the risk of early GFR loss increased linearly (9, 13, 20, 29, and 36%, respectively). This linear increase corresponds to odds ratio 1.4 (95% CI 1.1–1.8) per 1 mg/dl increase of uric acid. The progression and regression of urinary albumin excretion were not associated with uric acid.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>We found a clear dose-response relation between serum uric acid and risk of early GFR loss in patients with type 1 diabetes. Clinical trials are warranted to determine whether uric acid–lowering drugs can halt renal function decline before it becomes clinically significant.</jats:p> </jats:sec>
  • Zugangsstatus: Freier Zugang