Background. Diabetic nephropathy is one of the most serious complications of diabetes and can lead to end-stage renal disease if not managed effectively. It typically develops in stages, starting with early changes that may not show noticeable symptoms. Diabetic nephropathy remains a significant health concern, affecting approximately 20% to 50% of individuals with diabetes. Elevated levels of uric acid are thought to play a role in increasing kidney damage through mechanisms such as inflammation, oxidative stress, and endothelial dysfunction. These factors can worsen the progression of nephropathy in diabetic patients, potentially accelerating the decline in kidney function.
The objective of our study was to evaluate the effect of allopurinol on proteinuria in diabetic patients with nephropathy.
Material and methods. A total of 80 patients with type 2 diabetes mellitus and diabetic nephropathy (defined by proteinuria of at least 500 mg/24 hours and a serum creatinine level under 3 mg/dL) were enrolled in the study. Forty patients were randomly assigned to receive allopurinol (100 mg/day), while the remaining 40 were given a placebo. Both groups continued their prescribed antihypertensive and renoprotective medications, including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, without any changes in dosage. Proteinuria levels were compared at baseline, 2 months, and 4 months between the two groups.
Results. Each group included 19 men and 21 women. After 4 months, patients receiving allopurinol treatment showed significantly lower serum uric acid levels (p = 0.02), as well as 24-hour urine protein (p = 0.049) compared to the control group.
Conclusions. Low-dose allopurinol can reduce the severity of proteinuria after 4 months of treatment, likely by lowering serum uric acid levels. Therefore, allopurinol may serve as an effective and cost-efficient adjunct therapy for patients with diabetic nephropathy.
Keywords: uric acid reduction, proteinuria, diabetic nephropathy
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Address for correspondence:
Ergita NELAJ
Department of Internal Medicine, University Hospital Center “Mother Teresa”, Tirana, Albania
Address: Dibra’s Street, No 370, Tirana, Albania
Email: dr_ergi@yahoo.com; Phone +35-569-206-6148
