Chernyaeva A. O., Mykytyuk M. R.

THE SIGNIFICANCE OF DIABETIC NEPHROPATHY IN THE GENESIS OF HYPERURIKEMIA IN PATIENTS WITH TYPE 1 DIABETES

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About the author:

Chernyaeva A. O., Mykytyuk M. R.

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CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

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The study is devoted to a comprehensive analysis of the state of purine metabolism and determination of the importance of diabetic nephropathy in the genesis of hyperuricemia in patients with type 1 diabetes. The study included 181 patients with type 1 diabetes (94 women and 87 men), average age (42.5±12.1) years. Clinical, laboratory and instrumental research was performed on all of them. In whole blood, the hemoglobin content, the number of erythrocytes and platelets, in venous blood - the level of fasting and 2 hours after eating glycemia, glycosylated hemoglobin, the concentration of creatinine, uric acid, purine bases, fibrinogen, total cholesterol, triglycerides, high-density lipoprotein cholesterol, xanthine oxidase activity. The glomerular filtration rate was calculated according to the CKD-EPI formula (eGFRCKD-EPI) and renal clearance of uric acid. The excretion of albumin and uric acid was studied. Determining the importance of diabetic nephropathy in the genesis of hyperuricemia made it possible to establish that the decrease in uric acid excretion in patients with type 1 diabetes is due to either a decrease in the rate of glomerular filtration or inhibition of secretion at the level of nephron tubules. It has been proven that the duration of the disease determines hyperuricemia in patients with type 1 diabetes. In 61.7% of patients, the hypoexcretory type of hyperuricemia associated with disorders of renal excretion of uric acid is detected. The formation of hyperuricemia in patients with type 1 diabetes is related to the development of diabetic nephropathy. Patients with a serum concentration of uric acid ≥ 445 μmol/l have clinical and laboratory signs of chronic renal failure. Decreased renal excretion of uric acid due to hyperuricemia in patients with type 1 diabetes mellitus is usually realized due to impaired glomerular urate filtration.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2023 Issue 3, 170, 310-319 pages, index UDC 616.379-008.64:616.61:616.153.857

DOI:

10.29254/2077-4214-2023-3-170-310-319