Dialysis Clinic, Inc., Quality Management, 1500 Indian School Rd. NE, Albuquerque, NM, 87102, USA.
University of New Mexico, Albuquerque, NM, USA.
Curr Diab Rep. 2018 Mar 1;18(4):18. doi: 10.1007/s11892-018-0985-5.
Multiple experimental and clinical studies have identified pathways by which uric acid may facilitate the development and progression of chronic kidney disease (CKD) in people with diabetes. However, it remains uncertain if the association of uric acid with CKD represents a pathogenic effect or merely reflects renal impairment.
In contrast to many published reports, a recent Mendelian randomization study did not identify a causal link between uric acid and CKD in people with type 1 diabetes. Two recent multicenter randomized control trials, Preventing Early Renal Function Loss in Diabetes (PERL) and FEbuxostat versus placebo rAndomized controlled Trial regarding reduced renal function in patients with Hyperuricemia complicated by chRonic kidney disease stage 3 (FEATHER), were recently designed to assess if uric acid lowering slows progression of CKD. We review the evidence supporting a role for uric acid in the pathogenesis of CKD in people with diabetes and the putative benefits of uric acid lowering.
多项实验和临床研究已经确定了尿酸可能促进糖尿病患者慢性肾脏病（CKD）发生和进展的途径。然而，尿酸与 CKD 的相关性是否代表致病作用，或者仅仅反映了肾脏损害，目前仍不确定。
与许多已发表的报告相反，最近一项孟德尔随机研究并未发现 1 型糖尿病患者尿酸与 CKD 之间存在因果关系。最近两项多中心随机对照试验，即预防糖尿病早期肾功能丧失（PERL）和别嘌醇与安慰剂随机对照研究以评估高尿酸血症合并慢性肾脏病 3 期患者肾功能降低（FEATHER），旨在评估尿酸降低是否能减缓 CKD 的进展。我们综述了尿酸在糖尿病患者 CKD 发病机制中的作用以及降低尿酸的潜在益处的相关证据。
