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2017 ; 18
(1
): 162
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Identification of chronic kidney disease patient characteristics influencing the
renoprotective effects of febuxostat therapy: a retrospective follow-up study
#MMPMID28521802
Yamaguchi A
; Harada M
; Yamada Y
; Hashimoto K
; Kamijo Y
BMC Nephrol
2017[May]; 18
(1
): 162
PMID28521802
show ga
BACKGROUND: The ability of antihyperuricemic therapy to exert renoprotective
effects in patients with chronic kidney disease (CKD) is controversial. In the
present study, we studied patient characteristics that may mask favorable impact
of antihyperuricemic therapy on the progression of CKD. METHODS: This was a
single-center, retrospective, follow-up study. One-hundred and seventy-eight CKD
patients with hyperuricemia who received febuxostat therapy were included in this
study. Mean serum uric acid (mUA) level after treatment and changes in estimated
glomerular filtration rate (?eGFR) over 6 months were measured and their
correlation was examined. Patients were divided into two groups based on mUA, and
their ?eGFR were compared. These analyses were evaluated in various subgroups.
RESULTS: Febuxostat therapy markedly decreased UA level in any CKD stage patients
without resulting in serious adverse events. eGFRs of CKD patients in the
mUA < 6.0 mg/dl group were maintained, whereas those in the mUA ? 6.0 mg/dl group
decreased. A significant inverse correlation was observed between mUA and ?eGFR
(r = -0.16, p = 0.019). The renoprotective effects of febuxostat were significant
in the following subgroups: male patients, age < 70 years, systolic blood
pressure < 130 mmHg, normal cholesterol levels, and absence of diabetes.
Coexisting vascular risk factors appear to exert additive masking effects against
febuxostat renoprotection. CONCLUSIONS: The results of this study suggest that
various vascular risk factors markedly attenuate the renoprotective effects of
febuxostat.
|Adolescent
[MESH]
|Adult
[MESH]
|Age Distribution
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Comorbidity
[MESH]
|Febuxostat/*therapeutic use
[MESH]
|Female
[MESH]
|Follow-Up Studies
[MESH]
|Glomerular Filtration Rate/drug effects
[MESH]
|Humans
[MESH]
|Hyperuricemia/*drug therapy/*epidemiology/prevention & control
[MESH]