Yu Jin, Tu Xiao, Xu Kunyue, Tang Xuanli, Wu Yufan, Jiang Xue
Department of Nephrology, Hangzhou Traditional Chinese Medicine (TCM) Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.
Key Laboratory of Precise Prevention and Treatment of Rheumatism Syndrome of Renal Wind Disease, Hangzhou, China.
Front Endocrinol (Lausanne). 2025 Jan 24;16:1481977. doi: 10.3389/fendo.2025.1481977. eCollection 2025.
Hyperuricaemia is associated with the development of Diabetic kidney disease (DKD). However, the mechanism of hyperuricaemia causing the progression of DKD remain unclear.
This is a single-centre retrospective study. 155 biopsy-proven DKD patients were grouped into hyperuricaemia and non-hyperuricaemia groups. Kaplan-Meier analysis and landmark curves were performed to explore predictors of end-stage renal disease (ESRD), Cox regression analysis was used to screen for factors, a nomogram was constructed to predict the renal prognosis of DKD.
Patients in hyperuricaemia group had higher serum creatinine (Scr), degree of mesangial expansion and IFTA score and lower GFR, haemoglobin. SUA level was positively correlated with IFTA scores. The Kaplan-Meier curve and landmark analysis revealed worse survival in hyperuricaemia group, especially after 12 months. 11 variables, including age, sex, haemoglobin, Scr, SUA, and pathological score were collected to make a nomogram model. In the testing and training sets, the AUCs at 1, 3, and 5 years were 0.888, 0.939, and 0.886 and 0.947, 0.867, and 0.905, respectively.
The clinicopathologic manifestation of DKD patients with hyperuricaemia was much more severe, and hyperuricaemia predicted a worse renal prognosis. A new renal prognosis prediction model including SUA was constructed for DKD with higher accuracy.
高尿酸血症与糖尿病肾病（DKD）的发生发展相关。然而，高尿酸血症导致DKD进展的机制仍不清楚。
这是一项单中心回顾性研究。155例经活检证实的DKD患者被分为高尿酸血症组和非高尿酸血症组。采用Kaplan-Meier分析和标志性曲线来探索终末期肾病（ESRD）的预测因素，使用Cox回归分析筛选因素，构建列线图以预测DKD的肾脏预后。
高尿酸血症组患者的血清肌酐（Scr）、系膜扩张程度和间质纤维化及肾小管萎缩（IFTA）评分较高，而肾小球滤过率（GFR）、血红蛋白较低。血尿酸（SUA）水平与IFTA评分呈正相关。Kaplan-Meier曲线和标志性分析显示高尿酸血症组的生存情况较差，尤其是在12个月后。收集了年龄、性别、血红蛋白、Scr、SUA和病理评分等11个变量来构建列线图模型。在测试集和训练集中，1年、3年和5年的曲线下面积（AUC）分别为0.888、0.939、0.886和0.947、0.867、0.905。
高尿酸血症的DKD患者的临床病理表现更为严重，高尿酸血症预示着更差的肾脏预后。构建了一个包含SUA的新的DKD肾脏预后预测模型，其准确性更高。
