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阿托伐他汀和瑞舒伐他汀对慢性肾病患者肾脏保护作用差异对血清尿酸的影响。

Effects on serum uric acid by difference of the renal protective effects with atorvastatin and rosuvastatin in chronic kidney disease patients.

作者信息

Kose Eiji, An Taesong, Kikkawa Akihiko, Matsumoto Yoshiaki, Hayashi Hiroyuki

机构信息

Department of Pharmacotherapy, School of Pharmacy, Nihon University.

出版信息

Biol Pharm Bull. 2014;37(2):226-31. doi: 10.1248/bpb.b13-00418.

Abstract

Hyperuricemia and hyperlipidemia have attracted attention as progression factors for chronic kidney disease (CKD). In the drug treatment of hyperuricemia and hyperlipidemia complications, Atorvastatin (ATV), which inhibits urinary protein, increases glomerular filtration rate (GFR) and has renal protective effects, and Rosuvastatin (ROS) were found be suitable because they promote serum uric acid (SUA) excretion. However, these drugs were administered at very high doses in previous studies. In this study, we have investigated the effects of ATV or ROS on renal protective effects and their SUA levels before and three months after each drug administration in CKD patients. We retrospectively investigated outpatients presenting with CKD (stages 3) on the basis of their electronic medical records as subjects. Estimated GFR (eGFR) was significantly increased after ATV administration, whereas no change in eGFR was observed following ROS administration. Furthermore, SUA levels significantly decreased after ATV administration, whereas no changes were observed following ROS administration. Therefore, it may be not necessary to administer drugs that lower the SUA levels to patients presenting with hyperuricemia and hyperlipidemia complications associated with moderate renal failure, such as patients with at least stage 3 CKD. We consider that, by selecting ATV, the renal protective effects and SUA-lowering effect would be sufficient.

摘要

高尿酸血症和高脂血症作为慢性肾脏病(CKD)的进展因素已受到关注。在高尿酸血症和高脂血症并发症的药物治疗中,发现抑制尿蛋白、增加肾小球滤过率(GFR)并具有肾脏保护作用的阿托伐他汀(ATV)和瑞舒伐他汀(ROS)适合使用,因为它们能促进血清尿酸(SUA)排泄。然而,在以往研究中这些药物的给药剂量非常高。在本研究中,我们调查了ATV或ROS对CKD患者肾脏保护作用及其给药前和给药后三个月SUA水平的影响。我们基于电子病历对门诊CKD(3期)患者进行回顾性研究,将其作为研究对象。服用ATV后,估计肾小球滤过率(eGFR)显著升高,而服用ROS后未观察到eGFR有变化。此外,服用ATV后SUA水平显著降低,而服用ROS后未观察到变化。因此,对于患有与中度肾衰竭相关的高尿酸血症和高脂血症并发症的患者,如至少3期CKD患者,可能没有必要使用降低SUA水平的药物。我们认为,通过选择ATV,肾脏保护作用和降低SUA的作用将是足够的。

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