Febuxostat for Hyperuricemia in Patients with Advanced Chronic Kidney Disease

Tetsu Akimoto; Yoshiyuki Morishita; Chiharu Ito; Osamu Iimura; Sadao Tsunematsu; Yuko Watanabe; Eiji Kusano; Daisuke Nagata

doi:10.33393/dti.2014.1355

Authors

Tetsu Akimoto Green Town Clinic, Tochigi, Japan.
Yoshiyuki Morishita Yuki Clinic, Ibaraki, Japan.
Chiharu Ito Yuki Clinic, Ibaraki, Japan.
Osamu Iimura Kumakura Clinic, Tochigi, Japan.
Sadao Tsunematsu Yuki Clinic, Ibaraki, Japan.
Yuko Watanabe Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
Eiji Kusano Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
Daisuke Nagata Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.

DOI:

https://doi.org/10.33393/dti.2014.1355

Keywords:

febuxostat, chronic kidney disease, hemodialysis, uric acid, oxidative stress

Abstract

Febuxostat is a nonpurine xanthine oxidase (XO) inhibitor, which recently received marketing approval. However, information regarding the experience with this agent among advanced chronic kidney disease (CKD) patients is limited. In the current study, we investigated the effects of oral febuxostat in patients with advanced CKD with asymptomatic hyperuricemia. We demonstrated, for the first time, that not only the serum levels of uric acid (UA) but also those of 8-hydroxydeoxyguanosine, an oxidative stress marker, were significantly reduced after six months of febuxostat treatment, with no adverse events. These results encouraged us to pursue further investigations regarding the clinical impact of lowering the serum UA levels with febuxostat in advanced CKD patients in terms of concomitantly reducing oxidative stress via the blockade of XO. More detailed studies with a larger number of subjects and assessments of the effects of multiple factors affecting hyperuricemia, such as age, sex, and dietary habits, would shed light on the therapeutic challenges of treating asymptomatic hyperuricemia in patients with various stages of CKD.