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Allopourinol Effect on Reducing Proteinuria in Diabetic Retinopathy

Background: Diabetic nephropathy is the most prevalent cause of end stage renal disease (ESRD). Be¬sides, factors such as angiotensin-H, 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 dia¬betes mellitus (DM) and diabetic nephropathy with proteinuria (at least 500 mg/24h) and serum crea¬tinine (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 re¬ceptor 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 pres¬sure, 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 (lOOmg/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 admin¬istered as an adjuvant, cheap, and low side-effect therapy for patients with diabetic nephropathy. Keywords: Diabetic nephropathy, Uric acid, Allopurinol, Proteinuria.