Plasma uric acid and renal haemodynamics in type 2 diabetes patients.

Abstract

AIM:

Increased plasma uric acid (PUA) concentrations are associated with chronic kidney disease in type 2 diabetes (T2D) patients. The mechanisms involved remain unclear. We investigated the relation between PUA and (intra)renal haemodynamics in T2D patients without overt kidney disease.

METHODS:

Eighty-eight white men and women with T2D were included (age 64 (58-68) years; body mass index 30.9 (28.3-33.6) kg/m2 ; glycated haemoglobin 7.1 (6.8-7.6)%). Plasma UA and fractional excretion of UA were measured, while glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were assessed by inulin and PAH-clearance techniques, respectively. Effective renal vascular resistance was calculated (ERVR). Renal afferent and efferent arteriolar resistances and glomerular hydrostatic pressure were estimated. Relationships between PUA and fractional excretion of UA and (intra)renal haemodynamic parameters were evaluated by multivariable linear regression analyses.

RESULTS:

Plasma UA concentrations were at the higher end of the normal range in most participants: 342 ± 68 μmol/L or 5.7 ± 1.1 mg/dL (mean ± SD). In multivariable analyses, PUA concentrations were negatively associated with GFR (r = -0.471; P = 0.001), ERPF (r = -0.436; P = 0.003) and glomerular hydrostatic pressure (r = -0.427; P = 0.003). In contrast, PUA concentrations had a positive correlation with ERVR (r = 0.474; P = 0.001), but not with efferent vascular resistance. Fractional excretion of UA was not related to renal haemodynamics.

CONCLUSION:

Plasma UA was negatively associated to GFR, ERPF but positively related to ERVR in T2D patients without overt renal impairment. Plasma UA-related increase in ERVR may be related to increased arterial afferent tone, which may put the kidney at risk for renal damage through ischaemia.

• Authors: Danii Ls Suijk, Mark M Smits, Marcel Ha Muskiet, Lennart Tonneijck, Mark Hh Kramer, Jaap A Joles, Daniël H van Raalte
• Journal: Nephrology (Carlton, Vic.) (Nephrology (Carlton)) Vol. 25 Issue 4 Pg. 290-297 (Apr 2020) ISSN: 1440-1797 [Electronic] Australia
• PMID: 31429150 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2019 The Authors. Nephrology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Nephrology.

Chemical References

• Biomarkers
• Uric Acid

Topics

• Aged
• Biomarkers (blood)
• Body Mass Index
• Cross-Sectional Studies
• Diabetes Mellitus, Type 2 (blood, complications, physiopathology)
• Female
• Glomerular Filtration Rate (physiology)
• Humans
• Kidney (blood supply)
• Male
• Middle Aged
• Renal Insufficiency, Chronic (blood, etiology, physiopathology)
• Renal Plasma Flow, Effective (physiology)
• Uric Acid (blood)
• Vascular Resistance