非布司他治疗CKD3-4期糖尿病肾病合并高尿酸血症的疗效

doi:10.3969/j.issn.2095-9400.2020.05.006

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Abstract Objective: To evaluate the effect of febuxostat on patients with CKD3 and CKD4 stage diabetic nephropathy (DN) with hyperuricemia (HUA) through prospective randomized controlled clinical studies. Methods: Diabetic nephropathy patients [glomerular leachate (eGFR) 15-59 mL/(min·1.73 m-2)] combined HUA, who were treated in the Second Affiliated Hospital of Wenzhou Medical University from January 2017 to June 2019, were recruited as subjects. According to the eGFR value, patients were divided into CKD3 group [eGFR is 30-59 mL/(min·1.73 m-2)] and CKD4 [eGFR is 15-29 mL/(min·1.73 m-2)]. CKD3 group was further divided randomly as treatment group 1 and control group 1. CKD4 group was further divided randomly as treatment group 2 and control group 2. Blood glucose, blood pressure, lipids controlling and renin angiotensin inhibitors (RASI) treatment were performed on all groups in the meantime. Febuxostat was given to patients in treatment group 1 and treatment group 2. Serum uric acid (UA), serum creatinine (SCr), serum cystayl C (Cys-C), eGFR, 24 hours of urine protein quantification, albumin creatinine Ratio (ACR), neutrophi gelatinase-associated lipocalin (NGAL) and renin-angiotensin- aldosterone system (RASS) were observed after 24 weeks. Results: A total of 95 patients completed the study and were qualified for selection, among whom 26 were in the treatment group 1, 24 in the control group 1, 23 in the treatment group 2 and 22 in the control group 2. Significant differences were observed in the distribution of UA, SCr, Cys-C, eGFR, 24 hours of urinary protein quantification, ACR, NGAL and RASS at 24 weeks between CKD 3 treatment group1 and control group 1. There were significant differences in the distribution of UA, SCr, Cys-C, eGFR, ACR, NGAL and RASS between CKD4 treatment group 2 and control group 2 (P<0.05), but no significant difference in urine protein quantification (P>0.05). In treatment group 1, the UA standard rate was 95% after 24 weeks of treatment. In treatment group 2, the UA standard rate was 85% after 24 weeks of treatment. Conclusion: Febustat can improve renal function in patients with CKD3 and CKD4 stage DN with HUA and has proved to be safe.

Key words： febuxostat diabetic nephropathy hyperuricemia kidney function treatment

Received: 09 November 2019

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	ZHAO Yanling
	HUANG Wen
	SHI Zhen
	ZHU Yonglin

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https://xb.wmu.edu.cn/EN/ 10.3969/j.issn.2095-9400.2020.05.006 OR https://xb.wmu.edu.cn/EN/Y2020/V50/I5/382

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