الفهرس 
I. INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
In early diabetic nephropathy, patients are free of clinical symptoms and signs of nephropathy, With that in mind, earlier indicators of impending diabetic nephropathy are needed. Microalbuminuria, on the other hand, is not a predictor of diabetic nephropathy but instead the earliest sign of the nephropathy. The present study comprised; 76 patients with diabetes mellitus (20 100M and 56 NIDDM patients ) 53 were females and 23 males, their age ranged from 15 to 74 years with average age of 49 ± 12. Twenty eight control subjects, 6 males and 22 females their age ranged from 20 to 67 with average 42 ± 9. All studied cases were selected from the outpatient clinic of Diabetes and Endocrine Unit at Mansoura ’University Hospital, El-Mansoura, Egypt. of the studied cases had a history of intake of nephrotoxic drugs, previous cardiac, pulmonary, hepatic, renal or endocrine disorders other than OM. All the studied patients were subjected to complete urine analysis and serum creatinine estimation before inclusion in the study. Those with pyuria, haematuria, impaired renal functions were excluded from the study. Our patients and controls were subjected to immunogenetic study, the blood samples were collected and studied at Molecular Medicine section, Department of Medicine, University of Sheffield, Sheffield, UK. Twenty one nephropathic patients were selected for therapeutic trial study, 8 patients were hypertensive and 13 were normotensive. The patients received Ramipril, a long acting ACEI, at hypotensive doses (5 mg/day) for hypertensive patients or at normotensive doses (1.25 mg/day) for normotensive patients for 6 weeks duration, In conclusion, our study identified the following:- (1) Development of hypouricemia in diabetic patients may be a marker of hyperglycemia but it has no predictive value for the occurrence of diabetic nephropathy.