Kidney Week

Abstract: TH-PO454

A Randomized Controlled Trial of the Effects of Febuxostat Treatment on Markers of Endothelial Dysfunction and Renal Progression in Patients with CKD

Session Information

• CKD: Clinical, Outcomes, Trials - I
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Ninwisut, Nanthawut, Phramongkutklao hospital, Bangkok, Thailand

Nanthawut Ninwisut,

• Nata, Naowanit, Phramongkutklao hospital, Bangkok, Thailand

Naowanit Nata,

• Thimachai, Paramat, Phramongkutklao hospital, Bangkok, Thailand

Paramat Thimachai,

• Varothai, Narittaya, Phramongkutklao hospital, Bangkok, Thailand

Narittaya Varothai,

• Tangwonglert, Theerasak, Phramongkutklao hospital, Bangkok, Thailand

Theerasak Tangwonglert,

• Tasanavipas, Pamila, Phramongkutklao hospital, Bangkok, Thailand

Pamila Tasanavipas,

• Chaiprasert, Amnart, Phramongkutklao hospital, Bangkok, Thailand

Amnart Chaiprasert,

• Supasyndh, Ouppatham, Phramongkutklao hospital, Bangkok, Thailand

Ouppatham Supasyndh,

• Satirapoj, Bancha, Phramongkutklao hospital, Bangkok, Thailand

Bancha Satirapoj,

Background

Hyperuricemia relates to chronic kidney disease (CKD) progression, systemic inflammation and impaired endothelial function. Febuxostat, a novel nonpurine selective xanthine oxidase inhibitor, is potent and effective for decreasing serum uric acid levels. The study aimed to evaluate the effect of oral febuxostat on markers of endothelial dysfunction and renal function in CKD patients.

Methods

A total of 84 CKD stage III-IV patients with asymptomatic hyperuricemia were randomly assigned to either the febuxostat (40 mg/day, N=40) or the matching control (N=44) for 8 weeks. Serum uric acid, estimated glomerular filtration rate (eGFR), urine albumin, serum asymmetric dimethylarginine (ADMA), and high sensitivity C-reactive protein (hsCRP) were measured at baseline and at the end of study.

Results

Febuxostat administration significantly reduced the serum uric acid concentration in patients with CKD when compared with control [ -3.40 (95% CI -4.19 to -2.62) vs. -0.35 (95% CI -0.76 to 0.06) mg/dL; P<0.001, respectively]. No significant difference in the changes in serum ADMA, hsCRP, eGFR and albuminuria, was identified between the two groups. Subgroup analysis in patients with decline serum uric acid after treatment, mean eGFR showed a significant increase in the febuxostat group (P=0.022), but no significant change in the palcebo group (P=0.802). The difference GFR change between groups was 1.97 ml/min/1.73 m² with 95%CI 0.15 to 4.64 at 8 weeks (P=0.03). Adverse events specific to febuxostat were not observed.

Conclusion

Febuxostat effectively reduced serum uric acid in the population of CKD without effect to endothelial dysfunction and systemic inflammation. It was able to preserve renal function in subgroup CKD patients with lower serum uric acid level after treatment.