Allopourinol Effect on Reducing Proteinuria in Diabetic Retinopathy



Momeni A¹ ; Shahidi S² ; Seirafian S² ; Taheri S² ; Kheiri S³ Show Affiliations
Source: Journal of Isfahan Medical School Published:2010

Abstract

Background: Diabetic nephropathy is the most prevalent cause of end stage renal disease (ESRD). Besides, factors such as angiotensin-II, cytokines, and vascular endothelial growth factor (VEGF), uric acid may play a role as the underlying cause of diabetic nephropathy. Therefore, decreasing serum level of uric acid can be effective in treatment of diabetic nephropathy. Methods: This was a double-blinded, randomized, clinical trial in which 40 patients with type 2 diabetes mellitus (DM) and diabetic nephropathy with proteinuria (at least 500 mg/24h) and serum creatinine (Cr) level < 3 mg/dl were divided into two groups of 20. Case group received allopurinol (100 mg/day) and control group received placebo for four months. Administration of antihypertensive and renoprotective drugs (angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs)) continued for both groups, without changes in dosage. Findings: Each group consisted of 9 men and 11 women. There were no difference between two groups, regarding age, body mass index (BMI), duration of diabetes, systolic and diastolic blood pressure, fasting blood sugar, serum blood urine nitrogen (BUN), serum creatinine (Cr), serum potassium, and urine volume (P > 0.05). Serum level of uric acid and 24 hour urine protein were significantly lower in control group, after four months of receiving allopurinol, compared with control group (P < 0.05). Conclusion: Low dose allopurinol (100mg/day) reduces severity of proteinuria after four months of taking, which is probably due to decreasing the serum level of uric acid. So, allopurinol can be administered as an adjuvant, cheap, and low side-effect therapy for patients with diabetic nephropathy.