Association Between Time-Averaged Serum Uric Acid and Renal Outcomes in Patients with Type 2 Diabetes Mellitus with Chronic Kidney Disease: A Multicenter Retrospective Cohort Study.

Authors

Shaogui Zhang, Xuan Zhao, Jianteng Xie, Yifan Zhang, Yanhui Wang, Xiaojie Chen, Qiuling Li, Danfeng Liu, Runli Jia, Weiting He, Yaxi Zhu, Hanchen Hou, Sheng Li, Fanna Liu, Yiming Zhang, Rongshao Tan, Hongquan Peng, Jie Li, Wenjian Wang

Published in

Diabetes therapy : research, treatment and education of diabetes and related disorders. Jul 09, 2026. Epub Jul 09, 2026.

Abstract

The aim of this work is to explore the association of time-averaged serum uric acid (TA-SUA) with renal outcomes of type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD).
A cohort of T2DM with CKD from eight centers was followed from January 2013 to January 2023. A Cox proportional hazards regression model was designed to evaluate the association of TA-SUA with renal outcomes (defined as serum creatinine doubling, or initiation of dialysis, or kidney transplantation, or progression to end-stage kidney disease). Cox proportional hazards regression with cubic spline functions and smooth curve fitting were used to explore the nonlinear relationship. Detailed evaluations for TA-SUA were also performed using propensity score matching (PSM), subgroup analyses, and sensitivity analyses.
A total of 1072 patients were enrolled with a mean follow-up duration of 60.4 ± 5.6 months. The baseline prevalence of hyperuricemia was 46.1% (50.4% in male vs. 37.9% in female). Patients with TA-SUA < 360 μmol/l demonstrated significantly better renal survival compared to those with TA-SUA ≥ 360 μmol/l (adjusted hazard ratio 0.63, 95% confidence interval, 0.41-0.98; P = 0.038). Restriction cubic spline analysis showed a rapid risk increase when TA-SUA exceeded 360 μmol/l, which was confirmed by PSM (P < 0.001). Subgroup analyses and sensitivity analyses showed that patients with eGFR between 30 and 59 ml/min/1.73 m² were the most likely to benefit from maintaining TA-SUA < 360 μmol/l.
Long-term maintenance of relatively low TA-SUA levels is independently associated with slowed renal function decline and favorable renal outcomes among patients with type 2 DM with CKD.

PMID:
42424028
Bibliographic data and abstract were imported from PubMed on 09 Jul 2026.

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