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| Clinical Efficacy of Different Doses Febuxostat in the Treatment of Uric Acid End-stage Nephropathy |
| YIN Jun, QIU Jun-si, SHAO Fang |
| Department of Nephrology, Wuxi Second People's Hospital, Wuxi Jiangsu 214000, China |
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Abstract 【Objective】To investigate the clinical effects of febuxostat at different doses in the treatment of uric acid end-stage nephropathy (UAESN). 【Methods】A total of 98 UAESN patients treated in our hospital were selected and randomly divided into the observation group (n=49) and the control group (n=49).On the basis of conventional treatment, the observation group was given 20 mg febuxostat, and the control group was given 40mg febuxostat. Serum creatinine (SCr), glomerular filtration rate (eGFR), urinary microalbumin to creatinine ratio (ACR) and serum uric acid (SUA) were observed before and after treatment. Plasma viscosity (PV), whole blood low shear viscosity (ηL), whole blood high shear viscosity (ηH), malondialdehyde (MDA), advanced oxide protein product (AOPP), superoxide dismutase (SOD) and other oxidative stress indicators were recorded. The efficacy and adverse reactions of the two groups were compared. 【Results】Compared with before treatment, SCr and ACR were decreased, eGFR and SOD were increased, SUA, PV, ηL, ηH, MDA and AOPP were decreased after treatment (P<0.05). After treatment, there were no significant differences in SCr, ACR, eGFR, SUA, PV, ηL, ηH, MDA, AOPP and SOD between the two groups (P>0.05). There was no significant difference between the clinical efficacy of the observation group (91.84%) and the control group (95.92%) (P>0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (P<0.05). 【Conclusion】Based on conventional treatment, 20 mg febuxostat has the same effect as 40 mg febuxostat in aspect of improving renal function, hemorheology, relieving oxidative stress and clinical efficacy of UAESN, however, 20 mg febuxostat has better safety.
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Received: 04 December 2021
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[1] CHARLTON A. Is febuxostat use associated with increased risk of cardiovascular disease events? the answer is crystal clear[J].J Rheumatol,2021, 48(7): 965-966.
[2] ONG S G,DING H J. A single-centre experience of febuxostat as a second-line urate-lowering therapy[J].Malays Fam Physician,2021,16(1): 50-55.
[3] ECKARDT K U,KASISKE B L. Kidney Disease: Improving Global Outcomes[J].Nature Reviews Nephrology,2009,5(11):650-657.
[4] 中华中医药学会肾病分会. 尿酸性肾病的诊断、辨证分型及疗效评定(试行方案)[J].上海中医药杂志,2008,42(1):23-25.
[5] SRIVASTAVA A,KAZE A D,MCMULLAN C J,et al. Uric acid and the risks of kidney failure and death in individuals with CKD[J].Am J Kidney Dis,2018,71(3): 362-370.
[6] BELUR NAGARAJ S,PENA M J,JU W,et al. Machine-learning-based early prediction of end-stage renal disease in patients with diabetic kidney disease using clinical trials data[J].Diabetes Obes Metab,2020,22(12): 2479-2486.
[7] CHEWCHARAT A,CHEN Y,THONGPRAYOON C,et al. Febuxostat as a renoprotective agent for treatment of hyperuricaemia: a meta-analysis of randomised controlled trials[J].Intern Med J,2021,51(5): 752-762.
[8] HU A M,BROWN J N. Comparative effect of allopurinol and febuxostat on long-term renal outcomes in patients with hyperuricemia and chronic kidney disease: a systematic review[J].Clin Rheumatol,2020,39(11): 3287-3294.
[9] CHOI Y,NEOGI T,STAMP L,et al. New perspectives in rheumatology: implications of the cardiovascular safety of febuxostat and allopurinol in patients with gout and cardiovascular morbidities trial and the associated food and drug administration public safety alert[J].Arthritis Rheumatol,2018,70(11): 1702-1709.
[10] JORDAN A,GRESSER U. Side effects and interactions of the xanthine oxidase inhibitor febuxostat[J].Pharmaceuticals (Basel),2018,11(2): 51.
[11] 徐力,陈文莉,李永霞. 低剂量非布司他对中重度慢性肾脏病合并高尿酸血症患者的肾脏保护作用[J].广东医学,2018,39(7): 1087-1091. |
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2022, Vol. 39 
