TY - JOUR
T1 - Renoprotective effects of febuxostat in hyperuricemic patients with chronic kidney disease
T2 - a parallel-group, randomized, controlled trial
AU - Tanaka, Kenichi
AU - Nakayama, Masaaki
AU - Kanno, Makoto
AU - Kimura, Hiroshi
AU - Watanabe, Kimio
AU - Tani, Yoshihiro
AU - Hayashi, Yoshimitsu
AU - Asahi, Koichi
AU - Terawaki, Hiroyuki
AU - Watanabe, Tsuyoshi
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background: Hyperuricemia is associated with the onset of chronic kidney disease (CKD) and renal disease progression. Febuxostat, a novel, non-purine, selective xanthine oxidase inhibitor, has been reported to have a stronger effect on hyperuricemia than conventional therapy with allopurinol. However, few data are available regarding the clinical effect of febuxostat in patients with CKD. Methods: A prospective, randomized, open-label, parallel-group trial was conducted in hyperuricemic patients with stage 3 CKD. Patients were randomly assigned to treatment with febuxostat (n = 21) or to continue conventional therapy (n = 19). Treatment was continued for 12 weeks. The efficacy of febuxostat was determined by monitoring serum uric acid (UA) levels, blood pressures, renal function, and urinary protein levels. In addition, urinary liver-type fatty acid-binding protein (L-FABP), urinary albumin, urinary beta 2 microglobulin (β2MG), and serum high sensitivity C-reactive protein were measured before and 12 weeks after febuxostat was added to the treatment. Results: Febuxostat resulted in a significantly greater reduction in serum UA (−2.2 mg/dL) than conventional therapy (−0.3 mg/dL, P < 0.001). Serum creatinine and estimated glomerular filtration rate changed little during the study period in each group. However, treatment with febuxostat for 12 weeks reduced the urinary levels of L-FABP, albumin, and β2MG, whereas the levels of these markers did not change in the control group. Conclusion: Febuxostat reduced serum UA levels more effectively than conventional therapy and might have a renoprotective effect in hyperuricemic patients with CKD. Further studies should clarify whether febuxostat prevents the progression of renal disease and improves the prognosis of CKD.
AB - Background: Hyperuricemia is associated with the onset of chronic kidney disease (CKD) and renal disease progression. Febuxostat, a novel, non-purine, selective xanthine oxidase inhibitor, has been reported to have a stronger effect on hyperuricemia than conventional therapy with allopurinol. However, few data are available regarding the clinical effect of febuxostat in patients with CKD. Methods: A prospective, randomized, open-label, parallel-group trial was conducted in hyperuricemic patients with stage 3 CKD. Patients were randomly assigned to treatment with febuxostat (n = 21) or to continue conventional therapy (n = 19). Treatment was continued for 12 weeks. The efficacy of febuxostat was determined by monitoring serum uric acid (UA) levels, blood pressures, renal function, and urinary protein levels. In addition, urinary liver-type fatty acid-binding protein (L-FABP), urinary albumin, urinary beta 2 microglobulin (β2MG), and serum high sensitivity C-reactive protein were measured before and 12 weeks after febuxostat was added to the treatment. Results: Febuxostat resulted in a significantly greater reduction in serum UA (−2.2 mg/dL) than conventional therapy (−0.3 mg/dL, P < 0.001). Serum creatinine and estimated glomerular filtration rate changed little during the study period in each group. However, treatment with febuxostat for 12 weeks reduced the urinary levels of L-FABP, albumin, and β2MG, whereas the levels of these markers did not change in the control group. Conclusion: Febuxostat reduced serum UA levels more effectively than conventional therapy and might have a renoprotective effect in hyperuricemic patients with CKD. Further studies should clarify whether febuxostat prevents the progression of renal disease and improves the prognosis of CKD.
KW - Chronic kidney disease (CKD)
KW - Febuxostat
KW - Hyperuricemia
KW - Urinary albumin
KW - Urinary beta 2 microglobulin (β2MG)
KW - Urinary liver-type fatty acid-binding protein (L-FABP)
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U2 - 10.1007/s10157-015-1095-1
DO - 10.1007/s10157-015-1095-1
M3 - Article
C2 - 25676011
AN - SCOPUS:84951909002
VL - 19
SP - 1044
EP - 1053
JO - Clinical and Experimental Nephrology
JF - Clinical and Experimental Nephrology
SN - 1342-1751
IS - 6
ER -