title: Effect of treatment of hyperuricemia with allopurinol on blood pressure, creatinine clearence, and proteinuria in patients with normal renal functions.
abstract: BACKGROUND
  Hyperuricemia has been associated with the development of hypertension, cardiovascular, and renal disease. However, there is no data about the effect of lowering uric acid level on hypertension, renal function, and proteinuria in patients with glomerular filtration rate (GFR) >60 ml/min. We therefore conducted a prospective study to investigate the benefits of allopurinol treatment in hyperuricemic patients with normal renal function.
  
  
  METHODS
  Forty-eight hyperuricemic and 21 normouricemic patients were included in the study. Hyperuricemic patients received 300 mg/day allopurinol for three months. All patients' serum creatinine level, 24-h urine protein level, glomerular filtration rate, and blood pressure levels were measured at baseline and after three months of treatment.
  
  
  RESULTS
  A total of 59 patients completed the three-month follow-up period of observation. In the allopurinol group, serum uric acid levels, GFR, systolic and diastolic blood pressure, and C-reactive protein (CRP) levels significantly improved (P < 0.05). However, urine protein excretion remained unchanged (P > 0.05). No correlation was observed between changes in GFR and changes in CRP, or blood pressure in the allopurinol group. No significant changes were observed in the control group (P > 0.05).
  
  
  CONCLUSIONS
  We bring indirect evidence that hyperuricemia increases blood pressure, and decreases GFR. Hence, management of hyperuricemia may prevent the progression of renal disease, even in patients with normal renal function, suggesting that early treatment with allopurinol should be an important part of the management of chronic kidney disease (CKD) patients. Long-term follow-up studies are warranted to identify the benefits of uric acid management on renal function and hypertension.
authors: 35. Sokak, 81/5, Bahcelievler, Ankara, 06490, Turkey. drkanbay@yahoo.com
authors: Mehmet
authors: M
authors: Kanbay
authors: Adem
authors: A
authors: Ozkara
authors: Yusuf
authors: Y
authors: Selcoki
authors: Bunyamin
authors: B
authors: Isik
authors: Faruk
authors: F
authors: Turgut
authors: Nuket
authors: N
authors: Bavbek
authors: Ebru
authors: E
authors: Uz
authors: Ali
authors: A
authors: Akcay
authors: Ramazan
authors: R
authors: Yigitoglu
authors: Adrian
authors: A
authors: Covic
mesh_terms: D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use*; D003404:Creatinine / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology; D033461:Hyperuricemia / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011507:Proteinuria / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000493:Allopurinol; D003404:Creatinine
references: J Am Soc Nephrol. 2005 Jul;16(7):1909-19
references: 15843466
references: Hypertension. 2000 Mar;35(3):746-51
references: 10720589
references: Nephrol Dial Transplant. 2006 Feb;21(2):260-3
references: 16326746
references: J Hum Hypertens. 1996 Oct;10(10):683-9
references: 9004095
references: Circ J. 2005 Aug;69(8):928-33
references: 16041161
references: Nature. 2006 Mar 9;440(7081):237-41
references: 16407889
references: Am J Kidney Dis. 2004 Oct;44(4):642-50
references: 15384015
references: J Clin Endocrinol Metab. 1994 Jan;78(1):25-9
references: 8288709
references: Kidney Int. 2005 Jan;67(1):237-47
references: 15610247
references: Hypertension. 2001 Nov;38(5):1101-6
references: 11711505
references: Hypertension. 2003 Jun;41(6):1183-90
references: 12707287
references: Circulation. 2002 Jul 9;106(2):221-6
references: 12105162
references: Am J Kidney Dis. 1999 Feb;33(2):225-34
references: 10023633
references: Am J Epidemiol. 1985 Jan;121(1):11-8
references: 3964986
references: Nephrol Dial Transplant. 2006 Nov;21(11):3046-7
references: 16963481
references: J Hypertens. 2000 Jan;18(1):97-101
references: 10678549
references: Am J Physiol Renal Physiol. 2006 Mar;290(3):F625-31
references: 16234313
references: Am J Physiol Renal Physiol. 2001 Jul;281(1):F1-11
references: 11399641
references: Ann Intern Med. 2005 Oct 4;143(7):499-516
references: 16204163
references: Kidney Int. 2005 May;67(5):1739-42
references: 15840020
references: Nature. 2003 Oct 2;425(6957):516-21
references: 14520412
references: Mol Cell. 1998 Aug;2(2):275-81
references: 9734366
references: Hypertension. 2003 Jun;41(6):1287-93
references: 12743010
references: Diabetes Care. 1996 May;19(5):414-8
references: 8732701
references: Am J Kidney Dis. 2006 Jan;47(1):51-9
references: 16377385
references: Hypertens Res. 2001 Nov;24(6):691-7
references: 11768729
references: Stroke. 1998 Mar;29(3):635-9
references: 9506605
references: J Am Soc Nephrol. 2002 Dec;13(12):2888-97
references: 12444207
references: Am J Nephrol. 2003 Jan-Feb;23(1):2-7
references: 12373074
references: Metabolism. 2006 Oct;55(10):1293-301
references: 16979398
references: Kidney Int Suppl. 2005 Dec;(99):S82-6
references: 16336583
references: N Engl J Med. 1966 Sep 1;275(9):457-64
references: 5917940
references: J Biol Chem. 1991 May 5;266(13):8604-8
references: 2022672