Dataset Information

Effect of febuxostat on renal function in patients from South China with CKD3 diabetic nephropathy.

ABSTRACT:

Objective

To investigate the efficacy and safety of febuxostat on renal function in CKD stage 3 diabetic nephropathy patients.

Methods

Patients in our hospital with chronic kidney disease (CKD) stage 3 diabetic nephropathy (DN) complicated by high serum uric acid (360 µmol/L) were recruited. Patients were then divided into treatment group and control group according to the random number table method. All the patients received low purine diet, renin-angiotensin-aldosterone system (RAAS) inhibitors, and adequate routine hypoglycemic treatment. Febuxostat was employed only in the treatment group. The levels of blood uric acid (sUA), serum creatinine (Scr), cystatin C (cys-c), eGFR, 24-hour urine protein quantification, albuminuria, and creatinine ratio (ACR) were evaluated in all patients before and after treatment at 4, 8, 12, and 24 week.

Results

No difference was found before treatment between the two groups. After treatment at 4, 8, 12, and 24 week, the levels of sUA, SCr, cys-c, and eGFR between the two groups were significant different (P<0.05). There was no difference in 24-hour urine protein quantification, albuminuria, and creatinine ratio between two groups before treatment, and significant differences were observed after treatment. Fifty percent of patients from the treatment group achieved the treatment goal with 20 mg febuxostat at 4 weeks. Tubular markers were also decreased with the treatment.

Conclusions

Febuxostat can reduce uric acid and improve renal function effectively in patients with CKD stage 3 diabetic nephropathy, while being well tolerated. However, the conclusion is still uncertain due to the short term of the study.

SUBMITTER: Wen H

PROVIDER: S-EPMC7860659 | biostudies-literature | 2020 Oct-Dec

REPOSITORIES: biostudies-literature

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Publications

Effect of febuxostat on renal function in patients from South China with CKD3 diabetic nephropathy.

Wen Huang H Yongling Zhu Z Shuying Zheng Z Jiali Wang W Yanling Zhao Z

Jornal brasileiro de nefrologia 20201001 4

<h4>Objective</h4>To investigate the efficacy and safety of febuxostat on renal function in CKD stage 3 diabetic nephropathy patients.<h4>Methods</h4>Patients in our hospital with chronic kidney disease (CKD) stage 3 diabetic nephropathy (DN) complicated by high serum uric acid (360 µmol/L) were recruited. Patients were then divided into treatment group and control group according to the random number table method. All the patients received low purine diet, renin-angiotensin-aldosterone system ( ...[more]

PMID: 32701116

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Project description:Correlation of vascular endothelial function and coagulation factors with renal function and inflammatory factors in patients with diabetic nephropathy was analyzed. A total of 86 patients diagnosed with diabetes mellitus (DM) and admitted to the 89th Hospital of the People's Liberation Army (Weifang, China) from March 2014 to May 2017 were selected. Among them, 38 patients complicated with nephropathy were divided into the observation group and 48 patients without nephropathy into the control group. The general data of patients were collected, and the relevant biochemical indexes, vascular endothelial function, coagulation factors and renal function indicators and the levels of inflammatory factors were determined. In the observation group, the duration of DM was longer than that in the control group, and the levels of glycated hemoglobin (HbA1c), fasting plasma glucose (FPG) and fasting insulin (FINS), level of fibrinogen (FIB) were higher than those in the control group (p<0.05). Homocysteine (Hcy) and brachial artery blood flow in the observation group were higher than those in the control group. The levels of nitric oxide (NO) and flow-mediated dilation (FMD) were lower than those in the control group (p<0.05). Activated partial thromboplastin time (APTT) in the observation group was shorter than that in the control group (p<0.05). The levels of cystatin-C (Cys-C), serum creatinine (SCr), urea and ?2-microglobulin, levels of C-reactive protein (CRP), tumor necrosis factor-? (TNF-?) and interleukin-6 (IL-6) in peripheral serum in the observation group were greatly higher than those in the control group (p<0.05). It was concluded via the correlation analysis of vascular endothelial function and coagulation factor with renal function and inflammatory factors that SCr and CRP were negatively correlated with NO, and SCr and CRP were positively correlated with FIB. Serum inflammatory factors, coagulation function and vascular endothelial function are closely related to diabetic nephropathy, which are good reference indexes for the assessment of diabetic nephropathy.

Project description:Diabetic nephropathy (DN) is one of the major complications of diabetes and contributes significantly towards end-stage renal disease. Previous studies have identified the gene encoding carnosinase (CN-1) as a predisposing factor for DN. Despite this fact, the relationship of the level of serum CN-1 and the progression of DN remains uninvestigated. Thus, the proposed study focused on clarifying the relationship among serum CN-1, indicators of renal function and tissue injury, and the progression of DN. A total of 14 patients with minimal changes disease (MCD) and 37 patients with DN were enrolled in the study. Additionally, 20 healthy volunteers were recruited as control. Further, DN patients were classified according to urinary albumin excretion rate into two groups: DN with microalbuminuria (n = 11) and DN with macroalbuminuria (n = 26). Clinical indicators including urinary protein components, serum carnosine concentration, serum CN-1 concentration and activity, and renal biopsy tissue injury indexes were included for analyzation. The serum CN-1 concentration and activity were observed to be the highest, but the serum carnosine concentration was the lowest in DN macroalbuminuria group. Moreover, within DN group, the concentration of serum CN-1 was positively correlated with uric acid (UA, r = 0.376, p = 0.026) and serum creatinine (SCr, r = 0.399, p = 0.018) and negatively correlated with serum albumin (Alb, r = - 0.348, p = 0.041) and estimated glomerular filtration rate (eGRF, r = - 0.432, p = 0.010). Furthermore, the concentration of serum CN-1 was discovered to be positively correlated with indicators including 24-h urinary protein-creatinine ratio (24 h-U-PRO/CRE, r = 0.528, p = 0.001), urinary albumin-to-creatinine ratio (Alb/CRE, r = 0.671, p = 0.000), urinary transferrin (TRF, r = 0.658, p = 0.000), retinol-binding protein (RBP, r = 0.523, p = 0.001), N-acetyl-glycosaminidase (NAG, r = 0.381, p = 0.024), immunoglobulin G (IgG, r = 0.522, p = 0.001), cystatin C (Cys-C, r = 0.539, p = 0.001), beta-2-microglobulin (β2-MG, r = 0.437, p = 0.009), and alpha-1-macroglobulin (α1-MG, r = 0.480, p = 0.004). Besides, in DN with macroalbuminuria group, serum CN-1 also showed a positive correlation with indicators of fibrosis, oxidative stress, and renal tubular injury. Taken together, our data suggested that the level of CN-1 was increased as clinical DN progressed. Thus, the level of serum CN-1 might be an important character during the occurrence and progression of DN. Our study will contribute significantly to future studies focused on dissecting the underlying mechanism of DN.

Dataset Information

Effect of febuxostat on renal function in patients from South China with CKD3 diabetic nephropathy.

Objective

Methods

Results

Conclusions

Publications

Effect of febuxostat on renal function in patients from South China with CKD3 diabetic nephropathy.

Similar Datasets

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