Journal English

Woro Hapsari Wahyuningrum

Sylvia Rachmayati / Nina
Tristina
th

Basic role :
Various factors :
Inflammation
Age, poor glycemic
control, hypertension Endothelial
dysfunction
and smoking

The objective of the study was

to find an association between
serum uric acid level and
proteinuria level in Type 2
Diabetic patients

A cross sectional study (2011)

n = 60
Both gender
Age range : 41-81 yo
With type 2 diabetic
Patients BW was stable 3 months
History of gout (-)
Treated with allopurinol (-)

Body Mass Index

Patients history
Current medication
Insulin doses
Tobacco use
Family medical history

 Serum

creatinine
Uric acid
Hemoglobin A1c (HbA1c)
24 h proteinuria

Fasting
state

Results were expressed as mean +/- SD

Considered as statistically significant
when twosided P < 0.05
Independentsamples t-test
comparison variables between male &
female
Spearmans rho coefficient correlation test
correlation of BMI with serum uric acid
Partial correlation coefficient test
correlation of protenuria with serum uric acid

n = 60 T2D patients
Sex : Femal Male

56.7 % 42.3 %

age range: 41-81 years,

Mean

SD

Age

57 years

8.3 years

Serum
creatinin

0.98 mg/dL

0.028 mg/dL

Serum uric
acid

4.5 mg/dL

0.15 mg/dL

Proteinuria

388 mg/day

28.7 mg/day

(median = 303.5
mg/day)

female

VS
Serum uric
acid
HbA1c
Creatinine

P > 0.05

male

Serum
Uric acid

BMI

Significant
positive
association

r=
0.428 P
= 0.001

After adjusment for

weight

Serum
Uric acid

proteinuria

Significant
positive
association

r = 0.47
P < 0.001

Serum
Uric acid

BMI

Significant
positive
association

r=
0.428 P
= 0.001

 The

etiology of DN is complex &

remains to be clarified
Presently, diabetes is the leading cause
of endstage renal disease in the most
parts of the world
Although the progression of kidney
disease can be halted partially,
DN is still regarded as an irreversible &
progressive disease

 It

has to be essential to find the

pathophysiological mechanisms that
leads to the development and
progression of DN
In this study, was found the
significant positive association of
serum uric acid with level of
proteinuria, when adjusted for weight

 Previous

study

Hyperuricemia and its association with obesity

and various components of metabolic
syndrome have been documented
Hyperuricemia is also prevalent in patients
with chronic renal failure
hyperuricemia may have a pathogenic role in
the development and progression of chronic
renal failure, rather than simply reflecting
decreased renal uric acid excretion

 Previous

study

In diabetic patients, serum uric acid early in

the course of diabetes is significantly
associated with later development of
persistent macroalbuminuria
It was shown that kidney damage in
hyperuricemic rats is not dependent on
blood pressure and instead involves the
reninangiotensin system (RAS)

 Previous

study

An association between serum uric acid &

early loss of renal function has been shown in
patients with type 1 diabetes
In the study (Fukui et al) positive
correlation of serum uric acid and urinary
albumin excretion in 343 men with type 2
diabetes mellitus was shown
concluded that serum uric acid concentration
is associated with microalbuminuria and
subclinical atherosclerosis in men with type 2
diabetes mellitus

 Previous

study

in a study on Chinese diabetic patients,

found that hyperuricemia was significantly
associated with abnormal albuminuria in
patients without diuretics or use of
uricosuric agents or alcohol
concluded that hyperuricemia were
significantly related to the presence of
albuminuria in patients with diabetes
Elevated level of serum uric acid can lead to
lowgrade kidney injury without deposition
of uric acid crystals in animal models

Previous study
hyperuricemia in rats induced arteriolopathy of
preglomerular vessels, resulting in :
impaired autoregulation
glomerular hypertension
endothelial dysfunction

It was found that microvascular

disease in hyperuricemic rats occurs
independent of blood pressure and is
dependent on activation of the
systemic & local RAS & inhibition of
endothelial nitric oxide

Previous study

(Obermayr et al) serum uric

acid was found to be :
a predictor of new onset kidney
disease
independent of other risk factors

This study :
Serum

uric acid had a significant

positive association with DN
hypothesized that serum uric acid
plays a pathological role in the
development of DN in T2D
Suggestion studying of the effect of
lowering uric acid with allopurinol on
renal function in DN patients in future.

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