Elevated Serum Uric Acid Increases Risk of Diabetic Retinopathy and Kidney Disease: Study
Researchers have discovered in a new study that high serum uric acid (SUA) levels are highly correlated with the risk of diabetic retinopathy (DR) and chronic kidney disease (CKD) in patients with long-term diabetes. Eye and kidney complications of diabetes are a serious problem in clinical settings. The cross-sectional study at Shanghai General Hospital found an evident correlation of increased SUA levels with the progression of the disease. Based on these observations, it seems that SUA may be an important risk factor for diabetic complications. The study was published in BMC Diabetology & Metabolic Syndrome by Hanying Wang and colleagues.
This research studied 1015 diabetic patients who were assessed from October 2018 to October 2021. Patients were screened with SUA measurement, renal function tests, and DR examination by fundus photography. Multivariable ordinal logistic models were applied to obtain odds ratios (ORs) and 95% confidence intervals (CIs) to evaluate DR and CKD progression. In addition, receiver operating characteristics (ROC) curves were employed to determine SUA thresholds, by which subjects could be divided into low and high SUA groups.
Key Findings
• SUA Levels and CKD Progression: Increased SUA levels were observed in patients with later CKD stages versus stage 1 CKD (p < 0.001).
• SUA and Vision-Threatening Diabetic Retinopathy (VTDR): The levels of SUA were higher in VTDR patients than in patients with no DR (p = 0.019).
• Risk of DR: Higher SUA levels indicated a higher probability of DR (OR: 1.002; 95% CI: 1.001–1.004).
• Risk of CKD: Increased SUA levels indicated a higher risk of CKD (OR: 1.008; 95% CI: 1.006–1.011).
• Thresholds for Risk Rise: SUA values above 354.0 µmol/L (95% CI: 318.9–393.2) were linked to a 1.571-fold higher risk of DR (95% CI: 1.139–2.099, P = 0.006).
• SUA and Risk of CKD: SUA values above 361.0 µmol/L (95% CI: 339.2–386.3) were associated with a 1.395-fold higher risk of CKD (95% CI: 1.033–1.885, P = 0.030).
• Gender-Specific Analysis: Positive correlation of elevated SUA levels with DR and CKD in both male and female patients.
This research offers robust evidence for an independent association between high SUA levels and diabetic retinopathy and chronic kidney disease risks in long-term diabetic patients. The results highlight the probable predictive value of SUA in the prediction of diabetic complications, highlighting the importance of routine SUA monitoring in diabetes care.
Reference:
Wang, H., Gu, L., Ma, Y. et al. High levels of serum uric acid are associated with microvascular complications in patients with long-term diabetes. Diabetol Metab Syndr 17, 106 (2025).https://doi.org/10.1186/s13098-025-01656-1
