Study of Serum Uric Acid Levels in Diabetic Kidney Disease and its Association with Left Ventricular Hypertrophy and eGFR: A Cross-sectional Study

Abstract

Introduction: Cardiovascular diseases are a major cause of death among patients with Diabetic Kidney Disease (DKD). Left Ventricular Hypertrophy (LVH) is a threatening prognostic sign and an independent risk factor for cardiovascular mortality and morbidity. A number of epidemiological studies have proven that LVH is common in patients with DKD. Aim: To estimate the Serum Uric Acid (SUA) levels in DKD patients and its association with LVH and estimated Glomerular Filtration Rate (eGFR). Materials and Methods: The current study was a cross-sectional study conducted at KR Hospital, Mysuru, a teritary care hospital, in Mysuru, Karnataka, India, during the period from 1st January 2020 to 31st December 2020. which included 53 patients with DKD. The demographic data, relevant investigations like Renal Function Test (RFT), SUA levels, complete haemogram, Fasting Blood Sugar (FBS), Postprandial Blood Sugar (PPBS), glycosylated haemoglobin, Liver Function Tests (LFT), urine routine, Urine Albumin Creatinine Ratio (UACR), electrocardiogram, 2D echo were done. The results were tabulated, and the patients were classified into those with high and low SUA levels. They were also evaluated for the presence of additional risk factors like hypertension and Ischaemic Heart Disease (IHD). Data obtained was analysed statistically using Statistical Packages of Social Sciences (SPSS) version 21.0 software. Mean, Standard Deviation (SD), Chi-square test, and Fischer’s-exact tests were used where appropriate, with a p-value <0.05 considered statistically significant. Patients were classified into two groups, one with SUA more than 6.5 and the other with less than 6.5, as normouricaemia and hyperuricaemia, respectively. Results: The majority of the cases were in the age group of 51-60 years, accounting for 43.4%. Out of 53 patients, males constituted 60.4% and females 30.6%, with a male-to-female ratio of 1.52:1. Total 33 patients (62.3%) were hypertensive, 32 patients (60.4%) had LVH, and 15 patients (28.3%) had IHD. Among 38 patients with SUA levels >6.5 mg/dL, the mean UACR value was higher (1807.9 mg/gm), the mean eGFR value was 32.4 mL/min/1.73 m2, and the mean Left Ventricular Mass index (LVMI) was 117.1 g/m2, which was statistically significant. Conclusion: In patients with DKD, higher SUA levels were associated with significantly higher values of UACR, lower eGFR values, higher LVMI values, and an increased risk for LVH, hypertension, and IHD. However, there was no significant association between higher uric acid levels and HbA1c.