Effect of allopurinol on diabetic nephropathy; a double-blind clinical trial study

Abstract

Introduction: Diabetic nephropathy (diabetic kidney disease) is the most common cause of renal failure. Objectives: Regarding the role of allopurinol in the improvement of diabetic kidney disease, this study aimed to investigate the ameliorative effect of allopurinol in diabetic nephropathy patients. Patients and Methods: This double-blind clinical trial study was performed on 60 patients with diabetic kidney disease referenced to nephrology clinic during 2019-2020. Patients were divided into case (treated with allopurinol 100 mg/d) and control (received placebo pill) groups. Three and six months of intervention, complete blood count (CBC), fasting blood sugar levels (FBS), serum blood urea nitrogen (BUN) levels, creatinine (Cr) and uric acid (UA) levels, 24 hours urinary protein, glomerular filtration rate (GFR), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were measured and compared between the two groups. Results: After six months, reduction of UA and 24 hours urinary protein were not significant in t he control group (P > 0.05) but it was significant in the a l lopu r i nol g roup (P < 0.05). In the allopurinol group, NLR and PLR levels decreased significantly during the six months (P < 0.01) however t here was no significant change in the control group (P > 0.05). Conclusion: Low dosage of allopurinol (100 mg/d) reduces UA, proteinuria, NLR and PLR in patients after six months. Therefore it can be used for diabetic nephropathy patients as a supplementary, inexpensive and safe treatment. Trial registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20200117046158N1; https://irct.ir/trial/45533, ethical code; IR.SKUMS. R EC .1397. 303). © 2020, J Renal Inj Prev. All rights reserved