INTRODUCTION AND AIMS: Hyperuricemia is not infrequently encountered among hemodialysis patients. However, there is no clear data about the use of febuxostat among hemodialysis patients, apart from very small case series. The aim of this study is to investigate the efficacy of using febuxostat for the treatment of Hyperuricemia among hemodialysis patients.
METHODS: Nineteen hemodialysis patients with Hyperuricemia (Uric acid level above 6.0 mg/dL in females and 7.0 mg/dL in males) were enrolled in our study. Febuxostat 40 mg tab once every other day was given for 3 months. No change in Erythropoiesis-stimulating agents' doses or blood pressure medications was inclined during the study time. For patients using allopurinol, it was discontinued two months before enrollment in this study. Urea Reduction Rate, serum uric acid, electrolytes, liver function test, serum bicarbonate, complete blood count, intact parathyroid hormone and other blood chemistry tests were measured before and after the study. Paired T-test and Wilcoxon Signed Ranks Tests were used - when appropriate - through SPSS statistical package to perform statistical tests on the collected data.
RESULTS: Nineteen hemodialysis patients (11 males and 8 females) were enrolled in this study with a mean age 51.7± 9.2 years. Original kidney diseases were hypertension 42%, diabetes mellitus 47% and glomerular disease 11%, with median duration on regular hemodialysis of 33.4 ± 10 months. Serum uric acid level was decreased by a mean of 2.0 ± 0.7 mg/dL, about -31% from baseline (P < 0.001) after using febuxostat for 3 months. Serum alanine transferase level was increased by a mean of 2.6 ± 2.2 U/L (P < 0.001), while the serum aspartate transaminase level change was indifferent (0.2±1.4 U/L (P = 0.96). Urea reduction rate decreased after study from 63.5± 6.2 % to 62.0±7.2 %. However, this decrease was statistically insignificant (P = 0.57).
CONCLUSIONS: Febuxostat was effective in reducing serum uric acid level among hemodialysis patients with very mild elevation in serum alanine transferase in this study. |
