CORRELATION OF SERUM URIC ACID LEVEL WITH LEVEL OF URINARY ALBUMIN IN PATIENTS WITH DIABETIC NEPHROPATHY
DOI:
https://doi.org/10.71000/rbef0213Keywords:
Diabetic Mellitus, Diabetic Nephropathy, , Serum Uric Acid, Albuminuria, , Chronic Kidney Disease, Hyperuricemia, , Urinary ProteinsAbstract
Background: Diabetic nephropathy is a leading cause of chronic kidney disease worldwide, contributing significantly to morbidity and mortality among individuals with diabetes mellitus. Uric acid, a final product of purine metabolism, has been increasingly linked with renal dysfunction and progression of nephropathy. Albuminuria is considered a key marker of renal injury, reflecting glomerular and tubular damage. While extensive research has been conducted globally, limited evidence is available from Pakistan, where genetic diversity and varying environmental exposures may influence disease patterns.
Objective: This study aimed to evaluate the correlation between serum uric acid levels and urinary albumin excretion in patients with diabetic nephropathy.
Methods: This correlational study was conducted in the Department of Medicine, Khyber Teaching Hospital, Peshawar, between 26th September 2024 and 25th March 2025. A total of 84 patients, aged 18–70 years, with a confirmed diagnosis of diabetic nephropathy, were enrolled through non-probability consecutive sampling. Exclusion criteria included liver disease, gout, renal transplant, and medications influencing uric acid levels. Serum uric acid was measured from venous blood samples, and 24-hour urine collections were performed for albumin estimation. Data analysis was conducted using SPSS version 26, with Pearson correlation applied to assess the relationship between serum uric acid and urinary albumin.
Results: The mean age of participants was 50.65 ± 5.29 years, and the mean diabetes duration was 8.27 ± 3.09 years. Males comprised 44 patients (52.4%). Microalbuminuria was present in 46 patients (54.8%), while 24 patients (28.6%) had macroalbuminuria, and 14 patients (16.7%) had normal urinary albumin. Raised serum uric acid (>7.2 mg/dl) was detected in 26 patients (31.0%). The mean urinary albumin was 210.62 ± 197.14 mg/24 hr, and mean serum uric acid was 6.79 ± 1.25 mg/dl. Pearson correlation revealed a strong positive association (r = 0.788, p = 0.000) between urinary albumin and serum uric acid.Conclusion:
A significant positive linear correlation was established between serum uric acid and urinary albumin in diabetic nephropathy, suggesting that uric acid may serve as an additional marker of renal injury in diabetes.
References
Hassan Al-Bayati AA, Jawad Al-Khateeb SM. The association between glycaemic level and lipid profile with Albuminuria in Iraqi type 2 diabetes patients - A cross sectional study. J Pak Med Assoc. 2021;71(Suppl 8)(12):S57-s62.
Lai YJ, Chen YY, Ku PW, Chen LJ, Yen YF. Association between uric acid level and incidence of albuminuria in patients with type 2 diabetes mellitus: A 4.5-year cohort study. Medicine (Baltimore). 2021;100(41):e27496.
Hou L, Shi Y, Wang S, Chen Q, Li Q, Zhao M, et al. Associations of serum uric acid level with diabetic retinopathy and albuminuria in patients with type 2 diabetes mellitus. J Int Med Res. 2020;48(12):300060520963980.
Ma Y, Wang Q, Chen Y, Su J, Gao Q, Fan Y, et al. Correlation of dehydroepiandrosterone with diabetic nephropathy and its clinical value in early detection. J Diabetes Investig. 2022;13(10):1695-702.
Meremo A, Paget G, Duarte R, Dickens C, Dix-Peek T, Bintabara D, et al. Demographic and clinical profile of black patients with chronic kidney disease attending a tertiary hospital in Johannesburg, South Africa. PLoS One. 2022;17(9):e0266155.
Wu B, Chen L, Xu Y, Duan Q, Zheng Z, Zheng Z, et al. The Effect of Allopurinol on Renal Outcomes in Patients with Diabetic Kidney Disease: A Systematic Review and Meta-Analysis. Kidney Blood Press Res. 2022;47(5):291-9.
Zhu L, Sun J, Wang X, Tian R, Zhou Y, Yu J, et al. Elevated serum uric acid is not an independent risk factor for the occurrence of Type 2 diabetic kidney disease in Chinese populations. Medicine (Baltimore). 2022;101(50):e32128.
Qu YL, Dong ZY, Cheng HM, Liu Q, Wang Q, Yang HT, et al. Evaluation of Renal Impairment in Patients with Diabetic Kidney Disease by Integrated Chinese and Western Medicine. Chin J Integr Med. 2023;29(4):308-15.
Itano S, Kadoya H, Satoh M, Nakamura T, Murase T, Sasaki T, et al. Non-purine selective xanthine oxidase inhibitor ameliorates glomerular endothelial injury in Ins(Akita) diabetic mice. Am J Physiol Renal Physiol. 2020;319(5):F765-f72.
Bakris GL, Mikami H, Hirata M, Nakajima A, Cressman MD. A Non-purine Xanthine Oxidoreductase Inhibitor Reduces Albuminuria in Patients with DKD: A Randomized Controlled Trial. Kidney360. 2021;2(8):1240-50.
Cardoso CRL, da Silva Pereira L, Leite NC, Salles GF. Prognostic importance of baseline and changes in serum uric acid for macro/microvascular and mortality outcomes in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort. J Diabetes Complications. 2025;39(1):108921.
Kaewput W, Thongprayoon C, Chewcharat A, Rangsin R, Satirapoj B, Kaewput C, et al. Rate of kidney function decline and factors predicting progression of kidney disease in type 2 diabetes mellitus patients with reduced kidney function: A nationwide retrospective cohort study. Ther Apher Dial. 2020;24(6):677-87.
Heerspink HJL, Stack AG, Terkeltaub R, Greene TA, Inker LA, Bjursell M, et al. Rationale, design, demographics and baseline characteristics of the randomized, controlled, Phase 2b SAPPHIRE study of verinurad plus allopurinol in patients with chronic kidney disease and hyperuricaemia. Nephrol Dial Transplant. 2022;37(8):1461-71.
Choi C, Kim MG, Kim JH. Reno-protective effects of xanthine oxidase inhibitors in patients with type 2 diabetes and chronic kidney disease: a systematic review and meta-analysis. J Nephrol. 2025;38(2):393-401.
Oladi-Ghadikolaei R, Aliasgharzadeh A, Shayanfar A, Soleymani J, Moradi M, Jouyban A, et al. Serum Levels of Indoxyl Sulfate and P-cresol in Type II Diabetic Patients With and Without Nephropathy. Iran J Kidney Dis. 2023;17(3):126-34.
Jalal DI, Chertow GM. Urate Lowering With Combination Therapy in CKD: Reason for Optimism or Einstein's Definition of Insanity? Am J Kidney Dis. 2021;77(4):478-80.
Zeb S, Babar B, Bibi S, Shah MA. Correlation of uric acid with microalbuminuria in Type-2 diabetic patients with normal creatinine. Pak J Med Sci. 2024;40(5):951-955.
Chalak M, Farajollahi M, Amirkhanlou S. Evaluation of the relationship between serum uric acid level and proteinuria in patients with type 2 diabetes. J Clini Nephrol. 2023; 7: 001-006
Zhang F, Han Y, Zheng G, Li W. Gender Differences in the Incidence of Nephropathy and Changes in Renal Function in Patients with Type 2 Diabetes Mellitus: A Retrospective Cohort Study. Diabetes Metab Syndr Obes. 2024 Feb 26;17:943-957.
Naseri R, Amraee R, Eftekharzadeh A. Association between serum uric acid and proteinuria in patients with type 2 diabetes and stages 1 and 2 chronic kidney disease. Clinical Epidemiology and Global Health. 2020;8(1):166-169.
Jiang, J., Zhou, X., Lan, L. The correlation between serum uric acid and diabetic kidney disease in type 1 diabetes patients in Anhui, China. BMC Nephrol.2023;24:252.
Aladağ N,Türkmen FM. The Relationship Between Microalbuminuria and Serum Uric Acid Levels in Patients With Type 2 Diabetes Mellitus. South Clin Ist Euras. 2024;35(1):85-90.
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Copyright (c) 2025 Mahnoor Khattak, Muhammad Saeed Jan, Hammad Naeem, Sana Rahim Khan, Nayab Munib (Author)
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