Serum uric acid as an independent associated factor of early-stage renal impairment in patients with type 2 diabetes mellitus: a comparative cross-sectional study

Abstract

To evaluate the cross-sectional association between Serum Uric Acid (SUA) levels and the Estimated Glomerular Filtration Rate (eGFR) and to determine if SUA serves as an independent associated factor of Stage 2 Chronic Kidney Disease (CKD) in Type 2 Diabetes Mellitus (T2DM) patients. A hospital-based comparative cross-sectional study involving 200 participants (n = 100 T2DM patients and n = 100 age- and sex-matched healthy controls). Biochemical parameters (SUA, HbA1c, fasting blood glucose, lipid profile) were measured simultaneously. eGFR was calculated using the race-free CKD-EPI equation. Statistical analysis included Pearson’s correlation and multivariable linear regression adjusting for confounding variables. T2DM patients exhibited significantly higher SUA levels compared to healthy controls (7.4 ± 1.5 vs. 4.8 ± 1.1 mg/dL; p < 0.001). The mean eGFR in the diabetic group was 79.3 ± 13.1 mL/min/1.73 m², consistent with Stage 2 CKD. A significant negative correlation was established between SUA and eGFR (r = -0.44, p < 0.01). Multivariable linear regression identified SUA as a significant independent correlate of lower eGFR (β = -0.38, p < 0.001), after adjusting for age, BMI, HbA1c, sex, duration of diabetes, blood pressure, lipid profile, and proteinuria. Uncontrolled glycemic status (HbA1c ≥ 7%) was associated with elevated SUA levels. Elevated SUA is independently associated with early-stage renal impairment in T2DM. Integrating routine SUA measurement into diabetic monitoring protocols offers a cost-effective clinical tool for identifying patients with early renal function decline.