Kidney Week

Abstract: FR-PO0523

Urinary Succinate and Kidney Injury in Type 2 Diabetes Mellitus: A Cross-Sectional Analysis

Session Information

• CKM: Clinical - Trials, Epidemiology, and Biomarkers
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Cai, Ting, The Affiliated Wuxi Peolple’s Hospital of Nanjing Medical University, Wuxi Medical Center, Nanjing Medical University, Wuxi, Jiangsu, China

Ting Cai

• Jiao, Yihan, The Affiliated Wuxi Peolple’s Hospital of Nanjing Medical University, Wuxi Medical Center, Nanjing Medical University, Wuxi, Jiangsu, China

Yihan Jiao

• Wang, Liang, The Affiliated Wuxi Peolple’s Hospital of Nanjing Medical University, Wuxi Medical Center, Nanjing Medical University, Wuxi, Jiangsu, China

Liang Wang, MD

Background

Diabetic kidney disease (DKD) is a common microvascular complication in patients with type 2 diabetes mellitus (T2DM), yet reliable biomarkers for early detection and risk stratification remain limited. Succinate, a tricarboxylic acid (TCA) cycle intermediate, has recently been identified as a signaling molecule that has the potential to play a role in kidney diseases. In this study, we aim to investigate the association of urinary succinate levels with kidney injury in patients with T2DM with or without DKD.

Methods

A total of 240 participants were enrolled in the study, including 25 healthy controls, 40 patients with non-diabetic kidney disease(non-DKD), 85 patients with T2DM but without DKD (T2DM-DKD), and 90 patients with DKD (T2DM+DKD). The urinary succinate levels were measured by using a colorimetric assay kit.

Results

The urinary succinate levels were significantly elevated in patients with T2DM-DKD as compared with healthy controls, with the highest levels observed in patients with DKD among the four groups. Correlation analysis revealed a negative correlation between urinary succinate and eGFR, as well as a positive correlation between urinary succinate and serum creatinine, UACR, urinary NAG, and urinary NGAL in patients with DKD, however, in the T2DM-DKD group, urinary succinate was only correlated with urinary NAG. In multivariable models, after adjusting for potential confounders, urinary succinate demonstrated a persistent association with eGFR in patients with DKD. The receiver operating characteristic(ROC) analysis for eGFR<60ml/min/1.73m² in DKD yielded an area under the curve (AUC) of 0.70 at a log₁₀ (urinary succinate) cutoff of 1.36.

Conclusion

Urinary succinate levels are elevated in patients with T2DM, particularly those with DKD. This elevation in urinary succinate levels correlates with eGFR, independent of conventional risk factors in patients with DKD. These findings support the use of urinary succinate as a potential non-invasive biomarker for monitoring renal injury in diabetic patients and for risk stratification in DKD.