PMID- 24942770
OWN - NLM
STAT- MEDLINE
DCOM- 20150615
LR  - 20151119
IS  - 1348-4214 (Electronic)
IS  - 0916-9636 (Linking)
VI  - 37
IP  - 10
DP  - 2014 Oct
TI  - Safety, efficacy and renal effect of febuxostat in patients with 
      moderate-to-severe kidney dysfunction.
PG  - 919-25
LID - 10.1038/hr.2014.107 [doi]
AB  - Hyperuricemia (HU) is common in patients with chronic kidney disease (CKD), and 
      accumulating evidence suggests it has a pathogenic role in the progression of the 
      disease. However, a major challenge in treating patients with HU is the adverse 
      effects caused by urate-lowering drugs used to treat CKD. Because of these 
      untoward effects, doses need to be reduced, which leads to suboptimal efficacy. 
      Febuxostat has been shown to be highly efficacious in reducing serum uric acid 
      (sUA) and is well tolerated in patients with mild kidney dysfunction. However, 
      its safety and efficacy have not been well studied in more advanced cases of CKD. 
      We studied the safety and efficacy of escalating doses of febuxostat over a 
      24-week period in 70 patients with CKD stages 3b, 4 and 5, and we also observed 
      the changes in blood pressure, estimated glomerular filtration rate (eGFR) and 
      proteinuria following the reduction of sUA. Drug-related adverse events (AEs) 
      occurred in only 5 out of 70 patients. All but one of the events were mild, and 
      all five patients fully recovered. By 24 weeks, the reduction of sUA levels was 
      >40% in CKD stage 3b and >50% in CKD stages 4 and 5. More than 70% of patients 
      achieved target sUA levels of 6 mg dl(-1) or less. Multivariate analysis showed 
      that a greater reduction in sUA with febuxostat was associated with an increase 
      in eGFR and a tendency toward decreased proteinuria. Febuxostat was safe and 
      efficacious in the treatment of CKD stages 3b-5.
FAU - Shibagaki, Yugo
AU  - Shibagaki Y
AD  - Division of Nephrology and Hypertension, Department of Internal Medicine, St 
      Marianna University School of Medicine, Kawasaki, Japan.
FAU - Ohno, Iwao
AU  - Ohno I
AD  - Division of General Medicine, Department of Internal Medicine, Jikei University 
      School of Medicine, Tokyo, Japan.
FAU - Hosoya, Tatsuo
AU  - Hosoya T
AD  - Division of Kidney and Hypertension, Department of Internal Medicine, Jikei 
      University School of Medicine, Tokyo, Japan.
FAU - Kimura, Kenjiro
AU  - Kimura K
AD  - Division of Nephrology and Hypertension, Department of Internal Medicine, St 
      Marianna University School of Medicine, Kawasaki, Japan.
LA  - eng
PT  - Journal Article
DEP - 20140619
PL  - England
TA  - Hypertens Res
JT  - Hypertension research : official journal of the Japanese Society of Hypertension
JID - 9307690
RN  - 0 (Gout Suppressants)
RN  - 0 (Thiazoles)
RN  - 101V0R1N2E (Febuxostat)
RN  - 268B43MJ25 (Uric Acid)
SB  - IM
MH  - Aged
MH  - Blood Pressure/drug effects
MH  - Dose-Response Relationship, Drug
MH  - Endpoint Determination
MH  - Febuxostat
MH  - Female
MH  - Glomerular Filtration Rate/drug effects
MH  - Gout Suppressants/*adverse effects/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Proteinuria/drug therapy
MH  - Renal Insufficiency, Chronic/*drug therapy
MH  - Thiazoles/*adverse effects/*therapeutic use
MH  - Uric Acid/blood
EDAT- 2014/06/20 06:00
MHDA- 2015/06/16 06:00
CRDT- 2014/06/20 06:00
PHST- 2013/11/25 00:00 [received]
PHST- 2014/03/17 00:00 [revised]
PHST- 2014/04/27 00:00 [accepted]
PHST- 2014/06/20 06:00 [entrez]
PHST- 2014/06/20 06:00 [pubmed]
PHST- 2015/06/16 06:00 [medline]
AID - hr2014107 [pii]
AID - 10.1038/hr.2014.107 [doi]
PST - ppublish
SO  - Hypertens Res. 2014 Oct;37(10):919-25. doi: 10.1038/hr.2014.107. Epub 2014 Jun 
      19.