POSSIBILITIES OF RENOPROTECTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND HYPERURICEMIA
Liudmyla V Khimion1, Oleksandr A Burianov2, Iryna M Nayshtetik3
1SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE; KNP KOR KYIV REGIONAL CLINICAL HOSPITAL, KYIV, UKRAINE.
Insights
Febuxostat is more effective than allopurinol for lowering serum uric acid (sUA) in chronic kidney disease (CKD) patients. This treatment also shows renoprotective effects, improving glomerular filtration rate (GFR) in CKD patients.
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Elevated serum uric acid (sUA) is common in chronic kidney disease (CKD).
- Managing sUA is crucial for CKD patient outcomes.
- Allopurinol and febuxostat are common urate-lowering therapies.
Purpose of the Study:
- To compare the efficacy and safety of febuxostat and allopurinol in CKD patients.
- To assess the impact of these treatments on serum uric acid (sUA) levels.
- To analyze the influence of sUA reduction on glomerular filtration rate (GFR).
Main Methods:
- A study involving 45 CKD patients (stages 3b-5).
- Patients were divided into two groups: one receiving febuxostat and the other allopurinol.
- Comprehensive clinical and laboratory examinations were performed.
Main Results:
- Febuxostat achieved target sUA levels significantly more often than allopurinol at 1, 3, and 6 months.
- Lower sUA levels (<300 μmol/l) correlated with positive GFR changes in the febuxostat group.
- The allopurinol group showed a progression of GFR deterioration in 31.8% of patients.
Conclusions:
- Febuxostat demonstrates renoprotective abilities in pre-dialysis CKD patients.
- Febuxostat is safer and more effective than allopurinol for achieving target sUA levels in CKD stages 3b-4 and hemodialysis patients.
Objective:
The aim: To determine efficacy and safety of allopurinol and febuxostat in treatment of patients with CKD to reduce the sUA level and analyze its influence on glomerular filtration rate (GFR).
Patients And Methods:
Materials and methods: The study included 45 CKD patients (stages 3b-5) without other severe/decompensated diseases and contraindications to the allopurinol/febuxostat. All patients underwent a comprehensive clinical and laboratory examination, and were divided into the study groups: Group I (28 patients, 61,3±3,2 y.o., CKD3b-12, CKD4-10, on hemodialysis-6 patients) received febuxostat, Group II (24 patients, 60,7±4,1y.o., CKD3b-9, CKD4-10, on hemodialysis -5 patients) took allopurinol.
Results:
Results: Achievement of the target level of sUA was significantly often registered in Group I: after 1 month - in 45.5% (in group II - in 15.9%, p<0.001); after 3 months - in 67.5% (in group II - 21.2% p<0.01); after 6 months, these figures were 90% and 37.1%, respectively (p<0.01). sUA level <300 μmol/l was accompanied by significant positive GFR changes in group I patients; in group II there was a gradual progression of GFR deterioration in 31.8% of patients.
Conclusion:
Conclusions: In patients with pre-dialysis stages of CKD febuxostat demonstrates renoprotective abilities. Use of febuxostat in patients with CKD stage 3b-4 and in patients on hemodialysis is safe and more effective for target sUA level achievement than the use of allopurinol.
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