allopurinol and Kidney-Diseases--Cystic

: Allopurinol has been widely used for treatment of hyperuricemia, however, it may be associated with various adverse effects. Febuxostat has been identified as a potentially safe and efficacious alternative.. : A multicenter study with randomized, placebo-controlled, double-blind, parallel-group comparison was carried out to evaluate the efficacy and safety of febuxostat in 103 patients with hyperuricemia (including patients with gout) in Japan.. : Subjects were treated with febuxostat (20 or 40 mg/d) or a placebo for 8 weeks. The variables evaluated were the percentage of patients achieving serum uric acid levels 6.0 mg/dL or less and the percent change in serum uric acid levels after 8 weeks.. : The percentage of patients achieving serum uric acid levels 6.0 mg/dL or less after 8 weeks was 91.2% in the febuxostat 40-mg/d group, 45.7% in the 20-mg/d group, and 0.0% in the placebo group. The percent changes in serum uric acid levels after 8 weeks were -44.9% in the febuxostat 40-mg/d group, -28.9% in the 20-mg/d group, and -0.6% to -0.5% in the placebo group. No severe or medically significant adverse reaction attributable to febuxostat was noted, and there was no event that could pose a clinical problem. The efficacy did not differ depending on the presence/absence of gout history.. : These results suggest that febuxostat (20 or 40 mg/d) is useful as a new means of treating hyperuricemia and is capable of reducing serum uric acid levels to 6.0 mg/dL or less (goal of treatment) with high safety regardless of the presence/absence of gout history.

Topics: Adult; Central Nervous System Diseases; Dental Enamel; Diabetes Mellitus, Type 2; Dose-Response Relationship, Drug; Double-Blind Method; Febuxostat; Female; Follow-Up Studies; Gout; Gout Suppressants; Humans; Japan; Kidney Diseases, Cystic; Male; Middle Aged; Thiazoles; Treatment Outcome; Uric Acid; Xanthine Oxidase

In kidney transplant recipients (KTR), hyperuricemia (HU) is a commonly-observed phenomenon, due to calcineurin inhibitors and reduced kidney graft function. Factors predicting HU, and its association with graft function, remains equivocal.. There were 144 patients (mean age 46.6 ± 13.9), with 42.4% of them having HU. Predictors of HU in KTR were the presence of cystic diseases (OR = 9.68 (3.13; 29.9)), the use of diuretics (OR = 4.23 (1.51; 11.9)), and the male gender (OR = 2.45 (1.07; 5.56)). Being a younger age, of female gender, with a normal BMI, and the absence of diuretic medications increased the possibility of normal GFR. HU was the effect modifier of the association between demographic, clinical, and biochemical factors and a normal GFR.. Factors associated with HU in KTR: Presence of cystic diseases, diuretic use, and male gender. HU was the effect modifier of the association of demographic, clinical, and biochemical factors to GFR.

Topics: Adult; Calcineurin Inhibitors; Diuretics; Female; Glomerular Filtration Rate; Graft Survival; Humans; Hyperuricemia; Kidney; Kidney Diseases, Cystic; Kidney Transplantation; Logistic Models; Longitudinal Studies; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Risk Factors; Sex Factors; Transplants; Uric Acid; Xanthine Oxidase

Topics: Adult; Allopurinol; Gout; Humans; Kidney Diseases; Kidney Diseases, Cystic; Male; Uremia