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EFFICACY OF FEBUXOSTAT TREATMENT IN PATIENTS WITH ADVANCED CHRONIC KIDNEY DISEASE

INTRODUCTION AND AIMS: Hyperuricemia is common among renal patients. Many therapies are available for lowering acid uric levels. Febuxostat, a non-purine selective inhibitor of xanthine oxidize, is a novel alternative therapy of hyperuricemia treatment in patients with chronic kidney disease. Even though, there are small studies about the experience of non- purine oxidizes inhibitors among patients with Chronic Kidney Disease (CKD), febuxostat has been shown to be a potentially safe and efficacious alternative treatment in early stage of CKD.Aim of the study: The aim of the study was to evaluate the efficacy and safety of febuxostat in chronic kidney disease patients in stage 3 and 4.

METHODS: Thirty patients with chronic kidney disease, 17 man, 13 female, were enrolled in the study. Serum acid uric levels were above 7.0 mg/dL in all patients (10 patients had acid uric levels >7 mg/dl; 8 patients > 8 mg/dl, and 9 patients > 9 mg/dl). None of the patients had previously received anti-hyperuricemic agents. Creatinine clearance was above 25 mL/min. The patients follow up was 8 weeks. Febuxostat was administered at a dose of 80 mg/day for two months. The target serum acid uric level was ≤6.0 mg/dl.

RESULTS: The mean age was 62.5 ± 17.8 years. No significative difference between genders was observed. Diabetes Mellitus was found in 63 % patients; HTA in 87 % patients; gout in 17 % patients. We did not found significative difference in creatinine serum during the study (2.34 ± 0.9 vs 2.04 ± 0.43 p<0.17). Acid uric levels were significantly lower after febuxostat treatment (7.7 ±1.7 mg/dl vs 5.3 ± 0.7 mg/dl; p<0.001). At the end of two months, all the patients achieved target of serum acid uric levels <6mg/dl. No serious adverse event had been shown. No dose adjustment was required.

CONCLUSIONS: Febuxostat 80 mg daily showed a significant urate-lowering effect. We found that febuxostat was safety and efficacious in patients with mild to moderate renal impairment. Efficacy was greater in patients with higher levels of acid uric. Our study supports the use of febuxostat as the best option for the treatment of hyperuricemia for patients with mild to moderate kidney disease.