EXPLORING URIC ACID PROFILE IN DIABETIC NEPHROPATHY: A CROSS-SECTIONAL INVESTIGATION

Abstract

Background: Diabetes mellitus, particularly type 2, is a growing global health concern, with diabetic nephropathy being a leading microvascular complication. Serum uric acid (SUA), while physiologically an antioxidant, has been increasingly implicated in oxidative stress and renal impairment when chronically elevated. Hyperuricemia may contribute to the progression of diabetic kidney disease, making its early detection vital in managing long-term renal outcomes.

Objective: To determine the frequency of hyperuricemia in type 2 diabetic patients with nephropathy and to evaluate its relationship with diabetic kidney dysfunction in a local population.

Methods: This descriptive cross-sectional study was conducted at the Department of Medicine, Khyber Teaching Hospital, Peshawar, from 1st September 2024 to 28th February 2025. A total of 139 patients, aged 30 to 70 years, with confirmed diabetic nephropathy were included using convenience sampling. Diabetic nephropathy was identified by a urinary albumin-to-creatinine ratio (UACR) >30 mg/g, and diabetes was confirmed by HbA1c >6.5% or a history of antidiabetic therapy exceeding six months. Hyperuricemia was defined as SUA >6.0 mg/dL. Fasting blood samples were analyzed using Selectra XL chemistry analyzer. Data were processed using SPSS v20. Quantitative data were expressed as mean ± SD, and categorical variables were analyzed using Chi-square or Fisher’s exact test.

Results: The mean age of participants was 50.20 ± 6.17 years, with a mean BMI of 24.38 ± 2.71 kg/m² and a mean SUA level of 6.09 ± 1.74 mg/dL. Among the 139 patients, 119 (85.6%) were older than 45 years and 80 (57.6%) were male. Hyperuricemia was observed in 36 individuals (26.0%). A significant positive correlation was noted between SUA and both UACR (r = 0.949, p < 0.001) and diabetes duration (r = 0.955, p < 0.001).

Conclusion: Elevated serum uric acid levels were prevalent among diabetic patients with nephropathy and significantly associated with worsening albuminuria and longer disease duration. Routine monitoring of uric acid in diabetic care may help identify individuals at risk for renal complications and guide early intervention strategies.