MP300EFFECT OF FEBUXOSTAT ON RENAL FUNCTION IN CHRONIC KIDNEY DISEASE

Abstract

Introduction and Aims: Febuxostat, a novel, non-purine, selective xanthine oxidase inhibitor, has been used in patients with gout and/or hyperuricemia. In CKD (chronic kidney disease) patients, however, there are only few reports about the effect of febuxostat on renal function. Methods: We measured the values of estimated glomerular filtration rate (eGFR using CKD-EPI equation), serum creatinine (sCr), and uric acid (UA) just before and 12 months (12M) after febuxostat administration in CKD outpatients (eGFR < 60 mL/ min/1.73m2). Results: We collected data from 157 patients (male: 154, gout: 130, asymptomatic hyperuricemia: 27) and median age was 69 (range: 32-89). Fifty-six (35.7%) patients were diabetic and 145(92.4%) were hypertensive. Nonsteroidal anti-inflammatory drugs (NSAID) were prescribed to 20(12.7%) patients. In 52 (33.1%) patients, eGFR was less than 30 mL/min/1.73m2. Paired t-test showed that there was no change in eGFR (basal: 37.9 ± 12.8 mL/min/1.73m2 vs 12M: 38.6±15.2 mL/min/1.73m2, p = 0.33, 95% confidence interval of the difference (CI): -2.0 - 0.7), and sCr (basal: 1.97 ± 0.68 mg/dL vs 12M: 2.02 ± 0.88 mg/dL, p = 0.21, 95% CI: -0.11 - 0.03). Basal UA (7.0 ± 2.0 mg/dL) was decreased to 4.4 ± 1.7 mg/dL in 12M (p < 0.0001, 95% CI: 2.1 - 2.8). In 13 (8.3%) patients, eGFR was decreased by 25% or more (1 case of hemodialysis) and increased by 25% or more in 18 (11.5%) patients. Stage of CKD, proportion of NSAID administration and underlying diseases such as diabetes and hypertension did not show any difference between improved renal function group and aggravated one. Conclusions: In 12-months observational study, febuxostat showed no effect on renal function in CKD patients. The randomized prospective study is needed for further confirmative results.