A Meta-analysis of serum uric acid and diabetic nephropathy risk in type 2 diabetes

Jing ZhaoLingzhu Zhao^*

• Department of Orthopedics, Ninth Hospital of Xi'an, Xi'an, China

Objective: To explore the correlation between serum uric acid (SUA) levels and the risk of diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM), and to evaluate the potential clinical implications of uric acid-lowering interventions. Methods: Relevant studies on the relationship between serum uric acid levels and the risk of DKD in patients with type 2 diabetes mellitus were collected by systematically searching databases such as PubMed, Web of Science, and Cochrane Library. The quality of the included studies was evaluated using the Cochrane risk-of-bias assessment tool, and Meta-analysis was performed using RevMan 5.3 software. The primary outcome indicators included the incidence of DKD, the odds ratio (OR) and 95% confidence interval (CI) of the relationship between serum uric acid levels and the risk of DKD. Results: After retrieval and screening, 8 randomized controlled trials (RCTs) (with a sample size of 491) were included in the Meta-analysis. The results showed that the estimated glomerular filtration rate (eGFR) in the hyperuricemia group was lower than that in the normal group (MD=4.40, 95% CI [0.66, 8.14], P=0.02), with low heterogeneity; the risk of DKD was significantly increased (OR=1.85, 95% CI [1.52, 2.26], P<0.001), with moderate heterogeneity (I ² =49%). Sensitivity analyses confirmed the robustness of these findings, though the limited sample size and moderate heterogeneity suggest caution in generalizing the results. Conclusion: Elevated serum uric acid levels are significantly associated with an increased risk of DKD in patients with type 2 diabetes mellitus. Monitoring serum uric acid levels may help to identify high-risk individuals for DKD at an early stage and provide a reference for clinical intervention.