Therapeutic Research

Abstract

Background：Chronic kidney disease（CKD）is a common disease and risk factor of cardiovascular diseases. Hyperuricemia is one of the important factors to worsen CKD. However, there is no available drugs to lower the uric acid levels sufficiently in CKD patients. The aim of this study is to examine the efficacy and safety of febuxostat in CKD patients with moderate to severe renal dysfunction.Methods：Forty CKD patients with hyperuricemia were enrolled and febuxostat was prescribed newly or in place of allopurinol or benzbromalone. The maximum daily dose was 40 mg for the patients with 30≦estimated glomerular filtration rate（eGFR）＜60 mL／min／1.73 m2 and 20 mg for those with eGFR＜30. The primary efficacy end－point was reduction to and maintenance of serum urate levels＜6.0 mg／dL. Six month follow－up was preformed and the effect and tolerability of febuxostat was observed. Results：By using febuxostat, hyperuricemia was reduced significantly without severeside effects. Six mg／dL urate level achievement ratio increased from 5％to 50％, even though, among the other unachieved 20 patients, 13 patients had not received maximum dailydose. Seven mg／dL achievement ratio went up from 20％to 87.5％. Uric acid excretion was also decreased significantly and renal function was maintained.Conclusion：Febuxostat can be an effective and safe drug to treat hyperuricemia in patients with modetate to severe renal dysfunction. New target level for uric acid will be determined for CKD patients.