Tanaka Atsushi, Nakamura Tsukasa, Sato Eiichi, Node Koichi
Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
Division of Nephrology, Department of Internal Medicine, Shinmatsudo Central General Hospital, Matsudo, Japan.
Drugs R D. 2017 Mar;17(1):97-101. doi: 10.1007/s40268-016-0169-1.
Hyperuricemia is associated with the progression of chronic kidney disease (CKD) and cardiovascular diseases. Topiroxostat, a selective xanthine oxidase inhibitor, effectively reduces serum uric acid (UA) levels and urinary albumin excretion (UAE) in CKD patients. A 50-year-old Japanese man was referred to our hospital due to albuminuria and hyperuricemia, and renal biopsy showed a typical hyperuricemic arteriolopathy. Treatment with topiroxostat decreased serum UA levels (9.2 mg/dL at baseline to 6.4 mg/dL after 6 months), UAE (388 to 88 mg/g.cr), and urinary level of liver-type fatty acid-binding protein (28.8 to 19.8 µg/g.cr). Interestingly, topiroxostat treatment was associated with a trend towards improved flow-mediated dilation (5.4 to 5.8%). These results suggested that topiroxostat in CKD patients with hyperuricemia is potentially effective, not only for ameliorating renal damages but also for improving endothelial function beyond its UA-lowering action.
高尿酸血症与慢性肾脏病（CKD）和心血管疾病的进展相关。托匹司他是一种选择性黄嘌呤氧化酶抑制剂，可有效降低CKD患者的血清尿酸（UA）水平和尿白蛋白排泄量（UAE）。一名50岁的日本男性因蛋白尿和高尿酸血症转诊至我院，肾活检显示为典型的高尿酸血症性小动脉病变。托匹司他治疗使血清UA水平（基线时为9.2mg/dL，6个月后降至6.4mg/dL）、UAE（从388降至88mg/g.cr）以及肝型脂肪酸结合蛋白的尿水平（从28.8降至19.8µg/g.cr）均有所下降。有趣的是，托匹司他治疗与血流介导的血管舒张改善趋势相关（从5.4%至5.8%）。这些结果表明，托匹司他对高尿酸血症的CKD患者可能有效，不仅可改善肾脏损害，还可在降低尿酸作用之外改善内皮功能。
