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Researchers at the Joslin Diabetes Center in Boston noted that increased uric acid levels may appear before any significant change in urine albumin levels, the standard screening test for diabetic kidney disease.
In the study, the researchers checked serum uric acid concentration and urine albumin levels in 675 patients with type 1 diabetes. The results showed that 311 patients had microalbuminuria (small amounts of the protein albumin in the urine), an early sign of diabetic kidney disease. The other 364 patients had normal urine albumin levels.
While none of the patients had higher levels of albumin (albuminuria), one in five did have some impairment of kidney function.
"Our research showed that loss of kidney function takes place even in the absence of albuminuria in patients with type 1 diabetes," study author Dr. Elizabeth T. Rosolowsky said in a prepared statement.
But she and her colleagues found that serum uric acid level was consistently related to kidney function. The higher the levels of uric acid in the blood, the lower the kidney function.
"The serum concentration of uric acid in these patients varied in a manner consistent with its having played a role in this early loss of kidney function," Rosolowsky said.
The findings, published in the May issue of the Clinical Journal of the American Society of Nephrology, suggest that treatments to reduce uric acid may help slow the decline of kidney function in diabetes patients.
"Thus we have the hope of having a means to thwart the loss of kidney function while function is still a relatively preserved stage," Rosolowsky said.
She noted that serum acid levels can be modified using drugs or by decreasing the amount of protein in a person's diet.
"If follow-up studies, already under way, demonstrate that serum uric acid concentration predicts the course of early decline in kidney function, then clinical trials would be justified to test whether modifying serum uric acid concentration also modifies the course of renal function decline in type 1 diabetic patients with high normoalbuminuria or microalbuminuria," Rosolowsky said.
SOURCE: American Society of Nephrology, news release, March 2008
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