SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE; KNP KOR KYIV REGIONAL CLINICAL HOSPITAL, KYIV, UKRAINE.
BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE.
Wiad Lek. 2022;75(5 pt 1):1059-1063. doi: 10.36740/WLek202205102.
The aim: To determine efficacy and safety of allopurinol and febuxostat in treatment of patients with CKD to reduce the sUA level and analyze its influence on glomerular filtration rate (GFR).
Materials and methods: The study included 45 CKD patients (stages 3b-5) without other severe/decompensated diseases and contraindications to the allopurinol/febuxostat. All patients underwent a comprehensive clinical and laboratory examination, and were divided into the study groups: Group I (28 patients, 61,3±3,2 y.o., CKD3b-12, CKD4-10, on hemodialysis-6 patients) received febuxostat, Group II (24 patients, 60,7±4,1y.o., CKD3b-9, CKD4-10, on hemodialysis -5 patients) took allopurinol.
Results: Achievement of the target level of sUA was significantly often registered in Group I: after 1 month - in 45.5% (in group II - in 15.9%, p<0.001); after 3 months - in 67.5% (in group II - 21.2% p<0.01); after 6 months, these figures were 90% and 37.1%, respectively (p<0.01). sUA level <300 μmol/l was accompanied by significant positive GFR changes in group I patients; in group II there was a gradual progression of GFR deterioration in 31.8% of patients.
Conclusions: In patients with pre-dialysis stages of CKD febuxostat demonstrates renoprotective abilities. Use of febuxostat in patients with CKD stage 3b-4 and in patients on hemodialysis is safe and more effective for target sUA level achievement than the use of allopurinol.
确定别嘌醇和非布司他在降低 CKD 患者血尿酸（sUA）水平方面的疗效和安全性，并分析其对肾小球滤过率（GFR）的影响。
本研究纳入了 45 名无其他严重/失代偿性疾病和别嘌醇/非布司他禁忌证的 CKD 患者（3b-5 期）。所有患者均接受了全面的临床和实验室检查，并分为研究组：I 组（28 例，61.3±3.2 岁，3b-12 期 CKD、4-10 期 CKD、6 例血液透析）接受非布司他治疗，II 组（24 例，60.7±4.1 岁，3b-9 期 CKD、4-10 期 CKD、5 例血液透析）接受别嘌醇治疗。
I 组达标率明显高于 II 组：治疗 1 个月后为 45.5%（II 组为 15.9%，p<0.001）；治疗 3 个月后为 67.5%（II 组为 21.2%，p<0.01）；治疗 6 个月后分别为 90%和 37.1%（p<0.01）。I 组 sUA 水平<300 μmol/l 时，GFR 显著改善；而 II 组有 31.8%的患者 GFR 逐渐恶化。
在 CKD 未透析期患者中，非布司他具有肾脏保护作用。与别嘌醇相比，非布司他在 CKD 3b-4 期患者和血液透析患者中更安全、更有效地达到目标 sUA 水平。
