Uric acid lowering to prevent kidney function loss in diabetes: the preventing early renal function loss (PERL) allopurinol study.
Uric acid lowering to prevent kidney function loss in diabetes: the preventing early renal function loss (PERL) allopurinol study.
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DOI：
10.1007/s11892-013-0381-0
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发表时间：
2013-08
影响因子：
4.2
通讯作者：
Doria, Alessandro
中科院分区：
文献类型：
--
作者：
Maahs, David M.;Caramori, Luiza;Cherney, David Z. I.;Galecki, Andrzej T.;Gao, Chuanyun;Jalal, Diana;Perkins, Bruce A.;Pop-Busui, Rodica;Rossing, Peter;Mauer, Michael;Doria, Alessandro
关键词：
糖尿病肾病在1型糖尿病（T1D）患者中引起显著的发病率和死亡率。到目前为止，强化血糖和血压控制未能充分遏制这一问题，因此迫切需要新的治疗方法。多项观察将血清尿酸水平与肾脏疾病的发展和糖尿病的进展联系起来，并强烈认为降低尿酸应该作为一种新的干预措施进行测试。目前，预防早期肾功能丧失（PERL）联盟正在进行一项使用别嘌呤醇的试验试点。尽管PERL试验针对的是肾功能下降风险最高的T1D患者，但别嘌呤醇作为肾保护剂的使用也可能与更大一部分糖尿病患者相关。由于别嘌呤醇价格低廉且安全，即使对于相对低风险的患者，在早期阶段完成适当的试验之前，它也可能具有成本效益。
Diabetic kidney disease causes significant morbidity and mortality among people with type 1 diabetes (T1D). Intensive glucose and blood pressure control have thus far failed to adequately curb this problem and therefore a major need for novel treatment approaches exists. Multiple observations link serum uric acid levels to kidney disease development and progression in diabetes and strongly argue that uric acid lowering should be tested as one such novel intervention. A pilot of such a trial, using allopurinol, is currently being conducted by the Preventing Early Renal Function Loss (PERL) Consortium. Although the PERL trial targets T1D individuals at highest risk of kidney function decline, the use of allopurinol as a renoprotective agent may also be relevant to a larger segment of the population with diabetes. As allopurinol is inexpensive and safe, it could be cost-effective even for relatively low-risk patients, pending the completion of appropriate trials at earlier stages.
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