TO CORRELATE SERUM URIC ACID LEVELS AND MICROALBUMINURIA AS MARKERS OF DIABETIC NEPHROPATHY IN TYPE 2 DIABETES

Abstract

Background: Levels of ―serum uric acid‖ are linked to the beginning and advancement of diabetic nephropathy and as a risk factor independently for early kidney disease, helping to predict the progression of microalbuminuria. This study is aimed at finding the link and correlating microalbuminuria and ―serum uric acid‖ levels as markers of diabetic nephropathy. Methods: This is a prospective observational study conducted in the Medicine Department of R. L. Jalappa Hospital and Research Center on subjects with type-2 diabetes mellitus. Patients who meet the exclusion and inclusion criteria are recruited sequentially by convenient sampling til the sample size is attained, with the agreement of the institutional ethics committee. The key outcome parameters are ―serum uric acid‖ and microalbuminuria. Results: The study comprised 120 type-2diabetes patients with an average age of 58.05± 12.3 years, with 65.83 percent men and 34.17 percent females. The mean duration of diabetes in the study population was 6.28 ± 4.2 years. Based on ACR levels, 79.17% had diabetic nephropathy, and 20.83% with no diabetic nephropathy. The mean ―serum uric acid‖ is 6.6 ± 0.85 mg/dL. Conclusion: The ―serum uric acid‖ had a fair predictive validity in predicting diabetic nephropathy, as indicated by area under the curve of 0.767 (95% CI 0.66 to 0.88, p value < 0.001) in our study. It had a sensitivity of 63.16% (95% CI 52.64% to 72.83%), specificity 72.00% (95% CI 5.61% to 87.93%), false positive rate 28.00% (95% CI 12.07% to 49.39%), false negative rate 36.84% (95% CI 27.17% to 47.36%), positive predictive value 89.55% (95% CI 79.65% to 95.70%), negative predictive value 33.96% (95% CI 21.52% to 48.27%), with a total diagnostic accuracy of 65.00% (95% CI 55.76% to 73.48%). Between diabetic nephropathy and non-nephropathy, a statistically noteworthy difference in ―serum uric acid‖ was found. (p value<0.05). The connection between ―serum uric acid‖ and microalbuminuria (r=0.564) was slightly positive and significant statistically (p=0.001). Key words: Hyperuricemia, Type-2 diabetes mellitus, Diabetic nephropathy, Urine albumin-creatinine ratio (ACR), Microalbuminuria.