DIABETIC NEPHROPATHY;

CHANGES IN SERUM URIC ACID WITH ADVANCING STAGES

Abstract

Objectives: To compare serum uric acid levels in different stages of diabetic
nephropathy. Study Design: Descriptive analytical study. Setting: University of Health Science
Lahore. Period: February 2010 to January 2011. Subjects and methods: A sample size of
195 diabetic subjects. They were divided among normoalbuminuric, microalbuminuric and
macroalbuminuric groups, according to their daily urinary albumin excretion rate (AER), with
65 patients in each group. Their glomerular filtration rate (GFR), daily AER and serum uric
acid was evaluated by conducting tests on serum and urine samples. Statistics: Kruskal-
Wallis test and Mann-Whitney U test were used to observe differences of medians in different
groups. P value less than 0.05 was taken statistically significant. Results: There was majority of
males in microalbuminuric and macroalbuminuric groups while females were more in number
in normoalbuminuric group. Significant differences were found in serum urea concentration,
serum creatinine concentration, serum uric acid concentration, glomerular filtration rate, urinary
creatinine concentration, urine flow rate, daily albumin excretion rate and urinary albumin
concentration among the three groups. Urinary creatinine concentration and glomerular
filtration rate were in the highest ranges in normoalbuminuric group and in the lowest ranges
in macroalbuminuric group. While rest of the parameters (ie. age, duration of diabetes, serum
urea concentration, serum creatinine concentration, urine flow rate, daily AER , urinary albumin
concentration and serum uric acid concentration) were in the lowest ranges in normoalbuminuric
group and in the highest ranges in macroalbuminuric group. There was significant increase
serum uric acid levels in advancing stages of diabetic nephropathy. p <0.05 was taken
statistically significant. Conclusion: It is concluded that serum uric acid increases with the
advancing stages of diabetic nephropathy. Progressive decline in glomerular filtration rate and
gradual rise in serum creatinine level occurs throughout the course of diabetic nephropathy.