Serum Uric acid is a better indicator of kidney impairment than serum uric acid to creatine ratio ; a cross sectional study of type 2 diabetes mellitus patients

Richard K D Ephraim; Yaw A Awuku; Prince Numekevor; Felix Botchway; Prince Adoba; Emmanuel K Dadzie; Chris A Abrefa; Albert Abaka-Yawson

doi:10.1007/s40200-021-00746-x

Serum Uric acid is a better indicator of kidney impairment than serum uric acid to creatine ratio ; a cross sectional study of type 2 diabetes mellitus patients

J Diabetes Metab Disord. 2021 Feb 10;20(1):313-320. doi: 10.1007/s40200-021-00746-x. eCollection 2021 Jun.

Authors

Richard K D Ephraim¹, Yaw A Awuku², Prince Numekevor¹, Felix Botchway³, Prince Adoba¹, Emmanuel K Dadzie¹, Chris A Abrefa¹, Albert Abaka-Yawson⁴

Affiliations

¹ Department of Medical Laboratory Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
² Department of Medicine and Therapeutics, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana.
³ Department of Chemical Pathology, University of Ghana, Accra, Ghana.
⁴ Department of Medical Laboratory Science, School of Allied Health Sciences, University of Health and Allied Sciences, Ho‎, Ghana.

Abstract

Background: Type 2 diabetes mellitus (T2DM) patients are likely to develop kidney disease. The need to identify more accessible and cheaper diagnostic biomarkers cannot be overemphasized. This study investigated the ability of serum uric and uric acid to creatinine ratio in assessing the kidney function of T2DM patients and determined the relationship between serum uric acid to creatinine ratio and estimated glomerular filtration rate (eGFR).

Methods: One hundred and fifty-five (155) consented T2DM patients were recruited from the diabetes clinic of the Cape Coast Teaching hospital. Anthropometric variables and blood pressure were measured. Serum uric acid (SUA), serum creatinine and urine protein were estimated using standard protocols. Uric acid to creatinine ratio (UA:CR), eGFR were then calculated.

Results: From the receiver operator characteristic (ROC) curve obtained, serum uric acid was found to be a better predictor of impaired renal function than UA:CR at p = 0.0001. The uric acid levels of participants in the fourth quartile of each category was found to be significant at p = 0.010 and can be used as indicators of kidney function in these participants. According to the odds ratio, the UA:CR will not be suitable to be used as an indicator of kidney function in any of the participants because their odds ratios were all less than 1. A total of 29(18.7 %) participants were found to have CKD with their eGFR falling below 60 ml/mins per 1.73 m². A significant positive relationship was found between serum uric acid and the staging of CKD according to eGFR whiles a negative relationship was found with UA:CR and CKD (p < 0.0001).

Conclusions: Serum uric acid is a better indicator of renal impairment (eGFR < 60 ml/mins per 1.73 m²) than UA:CR in patients with type 2 diabetes mellitus.

Keywords: Creatinine; Estimated GFR; Kidney disease; Type 2 diabetes mellitus; Uric acid.