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Renoprotective effects of febuxostat in hyperuricemic patients with chronic kidney disease: a parallel-group, randomized, controlled trial

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Abstract

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.

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Acknowledgments

The authors would like to thank Atsuko Hashimoto and Hitomi Fukushima for their efforts in collecting and analysing serum samples, and Ayumi Kanno and Yuriko Kikuchi for their efforts in data collection.

Conflict of interest

All the authors have declared no competing interest.

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Authors and Affiliations

  1. Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Kenichi Tanaka, Masaaki Nakayama, Makoto Kanno, Hiroshi Kimura, Kimio Watanabe, Yoshihiro Tani, Yoshimitsu Hayashi, Koichi Asahi, Hiroyuki Terawaki & Tsuyoshi Watanabe

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  1. Kenichi Tanaka
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  2. Masaaki Nakayama
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Correspondence to Kenichi Tanaka.

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Tanaka, K., Nakayama, M., Kanno, M. et al. Renoprotective effects of febuxostat in hyperuricemic patients with chronic kidney disease: a parallel-group, randomized, controlled trial. Clin Exp Nephrol 19, 1044–1053 (2015). https://doi.org/10.1007/s10157-015-1095-1

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