Effect of allopurinol in slowing kidney disease progression in hyperuricemic children with CKD stages 1-3
- سال انتشار: 1397
- محل انتشار: ششمین کنگره بین المللی انجمن نفرولوژی کودکان ایران
- کد COI اختصاصی: CNAMED06_029
- زبان مقاله: فارسی
- تعداد مشاهده: 480
نویسندگان
Mashhad University of Medical Sciences, Mashhad, Iran
Rush University Medical College, Chicago, Illinois USA
Mashhad University of Medical Sciences, Mashhad, Iran
چکیده
Background Hyperuricemia is a leading risk factor for the development of chronic kidney disease (CKD). We hypothesized that lowering serum uric acid (SUA) with allopurinol in hyperuricemic children with CKD may reduce the risk of CKD progression.Patients and Methods A total of 91 children, aged 3-15 years, with elevated serum uric acid level (SUA) > 5.5 mg/dL and CKD stages 1-3 were prospectively randomized to receive allopurinol 5mg/kg/day (study group, n=49) or no treatment (control group, n=42) for 4 months. The primary and secondary outcomes were changes in estimated glomerular filtration rate (eGFR) (> 10 mL/min/1.73m2) and the SUA (> 1.0 mg/dL) from baseline values, respectively.Results Baseline age, gender, blood pressure (BP), body mass index (BMI), SUA, high- sensitive C-reactive protein (hsCRP), and eGFR were similar in allopurinol subjects and controls. Allopurinol treatment resulted in a decrease in SUA, a decrease in systolic and diastolic BP, a decrease in hsCRP and an increase in eGFR compared with the baseline values (p< 0.05 for all). No significant difference was observed in the control hyperuricemic subjects. In multiple regression analysis after incorporating variables (age, gender, BMI, systolic and diastolic BP, CRP, and SUA), eGFR was independently related to SUA both before and after treatments (p=0.03 vs. p=0.02, respectively). All patients in the study group tolerated allopurinol, and there was no adverse reactions observed by physical examination or reported by patients.Conclusion Treatment of hyperuricemia with Allopurinol in children with CKD stages 1-3, over a 4 month-period was associated with increased eGFR, lower SUA levels, and hsCRPکلیدواژه ها
Allopurinol, Children, Chronic Kidney Disease, High-sensitive C-reactive protein, Hyperuricemiaمقالات مرتبط جدید
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