The association of Hyperuricemia with progressive Diabetic Nephropathy in patients with Type II Diabetes mellitus

Background: Diabetic nephropathy (DN) is a progressive kidney disease caused by the damage to the capillaries in the kidneys' glomeruli. Uric acid is the end product of purine catabolism and is excreted in the urine. Uric acid can serve as an inflammatory factor and is attributed to bring about endothelial dysfunction. The causal role of uric acid in the development of diabetic nephropathy is unknown. This study aimed to evaluate the association of serum uric acid level and low levels of estimated glomerular filtration rate (eGFR) which is an indicator of renal disease progression in patients with Type II (T2D) diabetes mellitus. Methods: A cross sectional analytical observational study was conducted on 150 patients with T2D. Since the study was an observational study it involved no medical intervention. Venous blood samples were obtained in fasting state for determination of random blood sugar, serum creatinine, uric acid, (HbA1c) hemoglobin A1c (reference range 3.8-5.5%); and blood urea nitrogen (BUN). Using MDRD formula eGFR was calculated as = 186 x [serum creatinine]-1.154 x [Age] -0.203 x 0.742. The association of renal disease with T2D and the grading of the patients into different stages of renal failure was analysed by eGFR values. Results: Hundred and fifty diagnosed cases of T2D were included in the present study. The mean age of the study population was 63 ± 12.2. No significant age and gender related variation in serum uric acid level was noted in the study population. The prevalence of Hyperuricemia was 19.33%. The mean BMI was significantly higher among hyperuricemic subjects in comparison with normouricemic patients. Hyperuricemia was evident in 75% (n=18) of the subjects with diabetic nephropathy. Stage IV and stage V patients were associated with significantly very high (p < 0.01) uric acid levels. Conclusions: Serum uric acid has a significant positive association with diabetic nephropathy ultimately resulting in end stage renal disease. Treatment intervention is out of the scope of this study.