Long-term efficacy of hyperuricaemia treatment in renal transplant patients.
BACKGROUND
Although hyperuricaemia and gout are frequently found in renal transplant recipients, little has been published on the efficacy of urate-lowering therapy (ULT) in this patient population. We therefore examine the effects of allopurinol and benziodarone therapy in a cohort of renal transplant patients.


METHODS
We reviewed files from a cohort of 1328 patients that received renal transplantation. The selection criteria included: functioning allograft, hyperuricaemia for >12 months or gout, ULT lasting at least 1 year and at least two control measurements after the onset of ULT. Patients on azathioprine were treated with benziodarone to avoid azathioprine-allopurinol interactions.


RESULTS
Two-hundred and seventy-nine patients fulfilled the criteria for review. They were treated with 289 courses of ULT: 100 with allopurinol (mean dose: 376 mg/day/dl/min of creatinine clearance) and 189 with benziodarone (mean dose: 73 mg/day). The mean follow-up was 38 months. Both drugs were effective for the control of hyperuricaemia, but benziodarone caused greater reductions in serum uric acid levels, especially when used at mean doses of >75 mg/day. Severe side effects were uncommon, in both the allopurinol and benziodarone groups.


CONCLUSIONS
Both allopurinol and benziodarone were effective for the control of hyperuricaemia in renal transplantation. Benziodarone at doses >75 mg/day was more effective than allopurinol in reducing serum uric acid levels and also reduced the risk of azathioprine-allopurinol interactions.
Perez-Ruiz
Fernando
F
Hospital de Cruces, Rheumatology Section and Nephrology Division, Baracaldo, Pais Vasco, Spain. fperez@hcru.osakidetza.net
Gomez-Ullate
Pablo
P
Amenabar
Juan J
JJ
Zarraga
Sofía
S
Calabozo
Marcelo
M
Herrero-Beites
Ana M
AM
Nolla
Joan M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use*; D000963:Antimetabolites / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033461:Hyperuricemia / Q000188:drug therapy* / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
D000963:Antimetabolites; D000493:Allopurinol; D001379:Azathioprine