1. Increased serum uric acid predictor of DKD?

A recent study published in Diabetes Care shows that more than 25% of teens with type 2 diabetes have hyperuricemia, which increases their risks for developing hypertension, cardiovascular disease and kidney disease.

El Ghormli and colleagues explored the relationship between serum uric acid and hypertension or elevated urinary albumin excretion in adolescents with type 2 diabetes, by examining secondary outcomes data from the Treatment Options for Type 2 Diabetes in Adolescents and Youth trial.

Hyperuricemia, defined as serum uric acid levels of 6.8 mg/dL or higher, was present in 25.6% of the participants at baseline. Nearly one-fifth of participants (18.7%) had hypertension, which was confirmed by BP of 130/80 mm Hg or more at baseline, and 37.4% had the condition after 7 years of follow up. In addition, a urine albumin-to-creatinine ratio of 30 mg/g or more was observed in 6.1% of the population at baseline and in 18% after 7 years.

The researchers found independent associations between rising serum uric acid levels and hypertension development (HR = 1.2; 95% CI, 1-1.4) and increased urinary albumin excretion (HR = 1.2; 95% CI, 1-1.5). Reaching the serum uric acid level for hyperuricemia enhanced the odds for hypertension as well (HR = 1.84; 95% CI, 1.22-2.8). The connection between serum uric acid and urinary albumin excretion was most notable in boys compared with girls (P = .0004) and non-Hispanic white adolescents compared with non-Hispanic black and Hispanic adolescents (P = 0.02).

“Serum uric acid as a unified risk factor for the development of both diabetic kidney disease and CVD does not necessarily imply causation, but increasing evidence implicates serum uric acid in the pathogenesis of vascular complications in type 2 diabetes,” said researchers. Future directions involve examining the relationships between serum uric acid, retinopathy, neuropathy and other CVD markers.

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