title: Renoprotective effects of febuxostat in hyperuricemic patients with chronic kidney disease: a parallel-group, randomized, controlled trial.
abstract: BACKGROUND
  Hyperuricemia is associated with the onset of chronic kidney disease (CKD) and renal disease progression. Febuxostat, a novel, non-purine, selective xanthine oxidase inhibitor, has been reported to have a stronger effect on hyperuricemia than conventional therapy with allopurinol. However, few data are available regarding the clinical effect of febuxostat in patients with CKD.
  
  
  METHODS
  A prospective, randomized, open-label, parallel-group trial was conducted in hyperuricemic patients with stage 3 CKD. Patients were randomly assigned to treatment with febuxostat (n = 21) or to continue conventional therapy (n = 19). Treatment was continued for 12 weeks. The efficacy of febuxostat was determined by monitoring serum uric acid (UA) levels, blood pressures, renal function, and urinary protein levels. In addition, urinary liver-type fatty acid-binding protein (L-FABP), urinary albumin, urinary beta 2 microglobulin (β2MG), and serum high sensitivity C-reactive protein were measured before and 12 weeks after febuxostat was added to the treatment.
  
  
  RESULTS
  Febuxostat resulted in a significantly greater reduction in serum UA (-2.2 mg/dL) than conventional therapy (-0.3 mg/dL, P < 0.001). Serum creatinine and estimated glomerular filtration rate changed little during the study period in each group. However, treatment with febuxostat for 12 weeks reduced the urinary levels of L-FABP, albumin, and β2MG, whereas the levels of these markers did not change in the control group.
  
  
  CONCLUSIONS
  Febuxostat reduced serum UA levels more effectively than conventional therapy and might have a renoprotective effect in hyperuricemic patients with CKD. Further studies should clarify whether febuxostat prevents the progression of renal disease and improves the prognosis of CKD.
authors: Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan. kennichi@fmu.ac.jp.
authors: Kenichi
authors: K
authors: Tanaka
authors: Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
authors: Masaaki
authors: M
authors: Nakayama
authors: Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
authors: Makoto
authors: M
authors: Kanno
authors: Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
authors: Hiroshi
authors: H
authors: Kimura
authors: Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
authors: Kimio
authors: K
authors: Watanabe
authors: Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
authors: Yoshihiro
authors: Y
authors: Tani
authors: Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
authors: Yoshimitsu
authors: Y
authors: Hayashi
authors: Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
authors: Koichi
authors: K
authors: Asahi
authors: Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
authors: Hiroyuki
authors: H
authors: Terawaki
authors: Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
authors: Tsuyoshi
authors: T
authors: Watanabe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000188:drug therapy; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D050556:Fatty Acid-Binding Proteins / Q000652:urine; D000069465:Febuxostat / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D033461:Hyperuricemia / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000652:urine*; D014527:Uric Acid / Q000097:blood; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors*; D001613:beta 2-Microglobulin / Q000652:urine
chemical_list: D004791:Enzyme Inhibitors; D050556:Fatty Acid-Binding Proteins; D001613:beta 2-Microglobulin; D000069465:Febuxostat; D014527:Uric Acid; D014969:Xanthine Oxidase
keywords: Chronic kidney disease (CKD); Febuxostat; Hyperuricemia; Urinary albumin; Urinary beta 2 microglobulin (β2MG); Urinary liver-type fatty acid-binding protein (L-FABP)