Febuxostat for Hyperuricemia in Patients with Advanced Chronic Kidney Disease
Febuxostat for Hyperuricemia in Patients with Advanced Chronic Kidney Disease
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DOI：
10.4137/dti.s16524
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发表时间：
2014-01-01
影响因子：
2.7
通讯作者：
Nagata, Daisuke
中科院分区：
文献类型：
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作者：
Akimoto, Tetsu;Morishita, Yoshiyuki;Nagata, Daisuke
非布司他是一种非嘌呤黄嘌呤氧化酶（XO）抑制剂，最近获得了上市许可。然而，关于在晚期慢性肾病（CKD）患者中使用该药的经验的信息有限。在目前的研究中，我们研究了口服非布司他对晚期CKD合并无症状高尿酸血症患者的影响。我们首次证明，在非布司他治疗6个月后，不仅尿酸（UA）的血清水平，而且8-羟基脱氧鸟苷（一种氧化应激标志物）的血清水平都显著降低，没有出现不良事件。这些结果鼓励我们进一步研究非布司他降低晚期CKD患者血清UA水平的临床影响，通过阻断XO同时降低氧化应激。更详细的研究涉及更多的受试者，并评估影响高尿酸血症的多种因素（如年龄、性别和饮食习惯）的影响，将揭示治疗不同阶段CKD患者无症状高尿酸血症的治疗挑战。
Febuxostat is a nonpurine xanthine oxidase (XO) inhibitor, which recently received marketing approval. However, information regarding the experience with this agent among advanced chronic kidney disease (CKD) patients is limited. In the current study, we investigated the effects of oral febuxostat in patients with advanced CKD with asymptomatic hyperuricemia. We demonstrated, for the first time, that not only the serum levels of uric acid (UA) but also those of 8-hydroxydeoxyguanosine, an oxidative stress marker, were significantly reduced after six months of febuxostat treatment, with no adverse events. These results encouraged us to pursue further investigations regarding the clinical impact of lowering the serum UA levels with febuxostat in advanced CKD patients in terms of concomitantly reducing oxidative stress via the blockade of XO. More detailed studies with a larger number of subjects and assessments of the effects of multiple factors affecting hyperuricemia, such as age, sex, and dietary habits, would shed light on the therapeutic challenges of treating asymptomatic hyperuricemia in patients with various stages of CKD.