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10.2337/dc10-0227

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20332356!2875450!20332356
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suck abstract from ncbi


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pmid20332356      Diabetes+Care 2010 ; 33 (6): 1337-43
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  • High-normal serum uric acid increases risk of early progressive renal function loss in type 1 diabetes: results of a 6-year follow-up #MMPMID20332356
  • Ficociello LH; Rosolowsky ET; Niewczas MA; Maselli NJ; Weinberg JM; Aschengrau A; Eckfeldt JH; Stanton RC; Galecki AT; Doria A; Warram JH; Krolewski AS
  • Diabetes Care 2010[Jun]; 33 (6): 1337-43 PMID20332356show ga
  • OBJECTIVE: 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. RESEARCH DESIGN AND METHODS: 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). RESULTS: 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 m(2) (111-145), respectively. During the 6-year follow-up, significant association (P < 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: <3.0, 3.0-3.9, 4.0-4.9, 5.0-5.9, and >or=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. CONCLUSIONS: 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.
  • |Adolescent[MESH]
  • |Adult[MESH]
  • |Albuminuria/blood[MESH]
  • |Creatinine/blood[MESH]
  • |Cystatin C/blood[MESH]
  • |Diabetes Mellitus, Type 1/*blood/*complications[MESH]
  • |Disease Progression[MESH]
  • |Female[MESH]
  • |Glomerular Filtration Rate[MESH]
  • |Humans[MESH]
  • |Kidney Diseases/*blood/*etiology[MESH]
  • |Kidney Function Tests[MESH]
  • |Kidney/*pathology[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Uric Acid/*blood[MESH]


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