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The urate-lowering efficacy and safety of febuxostat versus allopurinol in Chinese patients with asymptomatic hyperuricemia and with chronic kidney disease stages 3–5

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Abstract

Background

While the dose of allopurinol is limited in patients with chronic kidney disease (CKD), information is lacking concerning the efficacy, safety, and maintenance dose of febuxostat in Chinese patients with hyperuricemia and with CKD stages 3–5.

Methods

A single center, prospective cohort study was conducted in patients with CKD stages 3–5 and with hyperuricemia who had not yet begun to undergo renal replacement therapy. We enrolled 208 patients who were newly treated with febuxostat (n = 112) or allopurinol (n = 96) in this study. The efficacy of febuxostat was determined by the proportion of patients with serum uric acid (sUA) < 360 µmol/L at the end of the study and changes of renal function.

Results

The target of sUA < 360 µmol/L was reached by 96.4% of participants in the febuxostat group and 37.5% in the allopurinol group at 6 months. The eGFR in the febuxostat group showed an increase from 28.45 to 30.65 mL/min/1.73 m2 at 6 months, while in the allopurinol group, the eGFR decreased from 28.06 to 24.39 mL/min/1.73 m2. Linear regression analysis showed that the reduction in sUA was significantly associated with an increase in eGFR and decrease in proteinuria. We found that 83.0% of the patients could remain with sUA < 360 µmol/L at a maintenance dose of febuxostat 20 mg/day.

Conclusion

Febuxostat had superior urate-lowering efficacy to that of allopurinol in Chinese Han patients with hyperuricemia with CKD stages 3–5, and the reduction in sUA levels was associated with a slower progression of renal function.

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Funding

The study was supported by grants from the National Natural Science Foundation of China (General Program) (81770679, 81470973) and Shandong Science and Technology Development Program (2010G0020222).

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Author notes

  1. Xuemei Liu and Huifang Wang contributed equally to the study.

Authors and Affiliations

  1. Department of Nephrology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, China

    Xuemei Liu, Huifang Wang, Ruixia Ma, Leping Shao, Wei Zhang, Wei Jiang, Congjuan Luo, Tingting Zhai & Yan Xu

Authors
  1. Xuemei Liu
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  2. Huifang Wang
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  3. Ruixia Ma
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  4. Leping Shao
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  5. Wei Zhang
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  6. Wei Jiang
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  7. Congjuan Luo
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  8. Tingting Zhai
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  9. Yan Xu
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Corresponding authors

Correspondence to Xuemei Liu or Yan Xu.

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All authors declared that they have no conflict of interest.

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This article does not contain any original studies with human participants by any of the authors.

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Liu, X., Wang, H., Ma, R. et al. The urate-lowering efficacy and safety of febuxostat versus allopurinol in Chinese patients with asymptomatic hyperuricemia and with chronic kidney disease stages 3–5. Clin Exp Nephrol 23, 362–370 (2019). https://doi.org/10.1007/s10157-018-1652-5

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  • DOI: https://doi.org/10.1007/s10157-018-1652-5

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