title: Effects of xanthine oxidase inhibitors on renal function and blood pressure in hypertensive patients with hyperuricemia.
abstract: Hyperuricemia may promote the progression of hypertension and renal dysfunction. However, the effects of hyperuricemia treatment on blood pressure and renal function in adult hypertensive patients with hyperuricemia remain unclear. A total of 137 hypertensive patients with hyperuricemia (96 men and 41 women; mean age of 67 years) who recently started taking xanthine oxidase inhibitors (allopurinol or febuxostat) as outpatients were recruited. Serum uric acid level, estimated glomerular filtration rate (eGFR, ml min(-1) per 1.73 m(2)) and blood pressure (mm Hg) were retrospectively compared immediately before and shortly after starting treatment with xanthine oxidase inhibitors. The mean blood pressure and the eGFR immediately before starting treatment were 128/71 mm Hg and 44.6 ml min(-1) per 1.73 m(2), respectively. Although the eGFR decreased from 46.6 to 44.6 ml min(-1) per 1.73 m(2) before starting treatment with xanthine oxidase inhibitors, it increased to 46.2 ml min(-1) per 1.73 m(2) (P=0.001, compared with immediately before treatment) without any significant changes in blood pressure after the administration of xanthine oxidase inhibitors. Multiple regression analysis revealed that the increase in eGFR after starting xanthine oxidase inhibitor treatment positively correlated with the changes in systolic blood pressure and negatively correlated with the changes in uric acid levels and the use of renin-angiotensin system inhibitors. These results suggest that xanthine oxidase inhibitors may delay the progression of renal dysfunction in adult hypertensive patients with hyperuricemia.
authors.affiliation: Dialysis Unit, University Hospital of the Ryukyus, Okinawa, Japan.|Department of Cardiovascular Medicine, Nephrology and Neurology University of the Ryukyus Graduate School of Medicine, Okinawa, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kohagura
authors.affiliation: Shuri-Jokamachi Clinic, Naha city, Okinawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tana
authors.affiliation: Shuri-Jokamachi Clinic, Naha city, Okinawa, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Higa
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology University of the Ryukyus Graduate School of Medicine, Okinawa, Japan.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Yamazato
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology University of the Ryukyus Graduate School of Medicine, Okinawa, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Ishida
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology University of the Ryukyus Graduate School of Medicine, Okinawa, Japan.
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Nagahama
authors.affiliation: Department of Cardiovascular Medicine, Nephrology and Neurology University of the Ryukyus Graduate School of Medicine, Okinawa, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sakima
authors.affiliation: Clinical Research Center, Tomishiro Central Hospital, Tomigusuku city, Okinawa, Japan.|Okinawa Heart and Renal Association, Naha city, Okinawa, Japan.
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Iseki
authors.affiliation: Dialysis Unit, University Hospital of the Ryukyus, Okinawa, Japan.|Department of Cardiovascular Medicine, Nephrology and Neurology University of the Ryukyus Graduate School of Medicine, Okinawa, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ohya
mesh_terms: D000368:Aged; D000493:Allopurinol / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D004791:Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D000069465:Febuxostat / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D033461:Hyperuricemia / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors*
chemical_list: D004791:Enzyme Inhibitors; D000069465:Febuxostat; D014527:Uric Acid; D000493:Allopurinol; D014969:Xanthine Oxidase