Outcome of Febuxostat treatment in hyperuricemic pre-dialysis chronic kidney disease patients

2020 ◽  
Vol 7 (2) ◽  
pp. 45-52
Author(s):  
Dineshowri Shrestha ◽  
Anil Baral ◽  
Kashyap Dahal ◽  
Juju Raj Shrestha ◽  
Rajani Hada
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Adverse Effects ◽  
Serum Uric Acid ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Mdrd Equation ◽  
Ckd Stage

Introduction: Hyperuricemia is a cause and effect of chronic kidney disease (CKD), accelerates its progression and predisposes to acute kidney injury. Present study aimed to find out the outcome of Febuxostat treatment in hyperuricemic pre-dialysis CKD patients. Method: This was a cross sectional study conducted in Nephrology department, Bir hospital, Nepal, during from February 2019 to January 2020, among pre-dialysis CKD stage 3-5 non dialysis (ND) patients with serum uric acid (SUA) >7 mg/d L who were treated with Febuxostat 40 mg once a day and followed up at one, two and three months. The baseline SUA, creatinine, estimated glomerular filtration rate (eGFR) calculated by the modification of diet in renal disease (MDRD) equation compared with values at follow up and according to CKD stages. The adverse effects and liver enzymes were recorded. Result: There were total 50 patients, mean age 54.2±16.5 years, male 31 (62%).There were significant reductions of SUA from baseline of 8.9±1.4to 7.1±1.2 vs 5.9±0.9 vs 4.7±1.0) at one, two and three month respectively, p=0.000 and increment of eGFR (ml/min/1.73m2) from 29.6±15.0 to 31.6±16.0, 33.6±16.6, 34.1±17.1, p=0.000.And 41 (82%) patients achieved uric acid < 6 mg/dl at three month. Significant reduction of uric acid in all CKD stages and increment of eGFR in CKD stage 3 and 4 were observed. Adverse effects were epigastralgia in 5 (10%) and joint pain in 13 (26%). Conclusion: Febuxostat is an effective serum uric acid lowering drug in pre-dialysis chronic kidney disease patients with improvement of kidney function.

Association between serum uric acid and chronic kidney disease in patients with hypertension: A multicenter nationwide cross‐sectional study

2019 ◽  
Vol 12 (4) ◽  
pp. 235-242 ◽  
Author(s):  
Wisit Kaewput ◽  
Charat Thongprayoon ◽  
Ram Rangsin ◽  
Prajej Ruangkanchanasetr ◽  
Tarun Bathini ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals A retrospective cross-sectional study of the associated factors of hyperuricemia in patients with chronic kidney disease

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052091922
Author(s):  
Li-Ping Guo ◽  
Qin Wang ◽  
Yu Pan ◽  
Yan-Lin Wang ◽  
Ze-Jin Zhang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Serum Uric Acid ◽  
Cross Sectional Study ◽  
Serum Phosphate ◽  
Sectional Study ◽  
Clinical Factors ◽  
Cross Sectional

Objective To investigate the prevalence of hyperuricemia in patients at different stages of chronic kidney disease (CKD) and the association of serum uric acid (SUA) with several clinical factors in a retrospective cross-sectional study of non-dialysis CKD patients at two hospitals in Shanghai, China. Methods The prevalence of hyperuricemia in CKD patients and the association of SUA with other clinical factors were examined using analysis of variance, chi-squared test, multivariate analysis, and other statistical methods. Results A total of 663 CKD patients were enrolled, of which approximately 52% had hyperuricemia. CKD patients with hyperuricemia had lower hemoglobin and estimated glomerular filtration rate (eGFR) levels but higher blood urea nitrogen, serum creatinine, and serum phosphate levels than those without hyperuricemia. Serum uric acid level was positively associated with age, blood urea nitrogen , serum creatinine, cystatin C, and serum phosphate and negatively associated with hemoglobin and eGFR. In addition, CKD patients with anemia and hyperphosphatemia had a higher prevalence of hyperuricemia than those without anemia or hyperphosphatemia. Conclusions The prevalence of hyperuricemia increased with CKD progression supporting the use of urate-lowering treatment for patients with CKD stage 1 to 4.

scholarly journals J-shaped Relationship Between Chronic Kidney Disease and Serum Uric Acid Levels: A Cross-sectional Study on the Korean Population

2021 ◽  
Vol 28 (4) ◽  
pp. 225-233
Author(s):  
Bon San Koo ◽  
Hye-Jin Jeong ◽  
Chang-Nam Son ◽  
Sang-Hyon Kim ◽  
Gheun-Ho Kim ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Cross Sectional Study ◽  
Korean Population ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Association between urbanisation and the risk of hyperuricaemia among Chinese adults: a cross-sectional study from the China Health and Nutrition Survey (CHNS)

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044905
Author(s):  
Xixi Yu ◽  
Cheng Zhu ◽  
Han Zhang ◽  
Ziyan Shen ◽  
Jing Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Cross Sectional Study ◽  
Chinese Adults ◽  
Nutrition Survey ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health And Nutrition

ObjectiveTo explore the association between urbanicity and hyperuricaemia (HUA) and whether urbanicity is an independent risk factor for HUA in Chinese adults.DesignData analysis from a cross-sectional survey.Setting and participants8579 subjects aged 18 years or older were enrolled in the study from the 2009 wave of the China Health and Nutrition Survey to analyse the association between urbanicity and HUA. We divided them into three categories according to urbanisation index (low, medium and highly urbanised groups).Main outcome measuresHUA was defined as serum uric acid ≥7 mg/dL in men and ≥6 mg/dL in women.ResultsThe prevalence of HUA in low, medium and highly urbanised groups was 12.2%, 14.6% and 19.8%, respectively. The independent factors influencing serum uric acid included age, gender, hypertension, diabetes, chronic kidney disease, drinking, obesity and community-level urbanisation index (β=0.016, p<0.001). The risk of HUA in the highly urbanised group was significantly higher than that of the low urbanised group (OR 1.771, 95% CI 1.545 to 2.029, p<0.001), even after adjusting for other covariates (OR 1.661, 95% CI 1.246 to 2.212, p=0.001). In a subgroup analysis, we found that age, gender, comorbidity (such as hypertension, diabetes, obesity and chronic kidney disease) and physical activity affected the association between urbanisation and the risk of HUA.ConclusionsOur findings suggest that living in highly urbanised areas is linked with higher risk of HUA independent of cardiometabolic and health-related behavioural risk factors, which have been shown to increase along with urbanisation.

scholarly journals FGF-23 and Phosphate in Children with Chronic Kidney Disease: A Cross-Sectional Study in Kazakhstan

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 15
Author(s):  
Altynay Balmukhanova ◽  
Kairat Kabulbayev ◽  
Harika Alpay ◽  
Assiya Kanatbayeva ◽  
Aigul Balmukhanova
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Fibroblast Growth Factor 23 ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ckd Stage ◽  
Advanced Stages ◽  
Fgf 23 ◽  
Stage 1

Background and objectives: Chronic kidney disease (CKD) in children is a complex medical and social issue around the world. One of the serious complications is mineral-bone disorder (CKD-MBD) which might determine the prognosis of patients and their quality of life. Fibroblast growth factor 23 (FGF-23) is a phosphaturic hormone which is involved in the pathogenesis of CKD-MBD. The purpose of the study was to determine what comes first in children with CKD: FGF-23 or phosphate. Materials and Methods: This cross-sectional study included 73 children aged 2–18 years with CKD stages 1–5. We measured FGF-23 and other bone markers in blood samples and studied their associations. Results: Early elevations of FGF-23 were identified in children with CKD stage 2 compared with stage 1 (1.6 (1.5–1.8) pmol/L versus 0.65 (0.22–1.08), p = 0.029). There were significant differences between the advanced stages of the disease. FGF-23 correlated with PTH (r = 0.807, p = 0.000) and phosphate (r = 0.473, p = 0.000). Our study revealed that the elevated level of FGF-23 went ahead hyperphosphatemia and elevated PTH. Thus, more than 50% of children with CKD stage 2 had the elevating level of serum FGF-23, and that index became increasing with the disease progression and it achieved 100% at the dialysis stage. The serum phosphate increased more slowly and only 70.6% of children with CKD stage 5 had the increased values. The PTH increase was more dynamic. Conclusions: FGF-23 is an essential biomarker, elevates long before other markers of bone metabolism (phosphate), and might represent a clinical course of disease.

scholarly journals Performance of CKD-EPI equation to estimate glomerular filtration rate as compared to MDRD equation in South Brazilian individuals in each stage of renal function

2014 ◽  
Vol 52 (12) ◽  
Author(s):  
Francisco Veríssimo Veronese ◽  
Eduardo C. Gomes ◽  
Joana Chanan ◽  
Maicon A. Carraro ◽  
Eduardo G. Camargo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Disease Epidemiology ◽  
Mdrd Equation ◽  
Estimate Glomerular Filtration Rate

AbstractThe Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation seems to correct the overdiagnosis of chronic kidney disease (CKD) provided by Modification of Diet in Renal Disease (MDRD) equation. However, this point has not been tested in some ethnic groups. This study investigated the performance of MDRD and CKD-EPI equations in South Brazilian individuals.This cross-sectional study included 354 individuals including healthy volunteers, diabetic and non-diabetic individuals with or without CKD. Glomerular filtration rate (GFR) was measured by theIn the group as a whole,CKD-EPI reduces GFR underestimation in individuals with GFRs >60, but still presents a quite low accuracy at this GFR range. Moreover, it tends to overestimate GFR in subjects with GFRs <60 mL/min/1.73 m

scholarly journals Association of uric acid and uric acid to creatinine ratio with chronic kidney disease in hypertensive patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Nathalia Rabello Silva ◽  
Camila Evangelista Torres Gonçalves ◽  
Danilo Lemes Naves Gonçalves ◽  
Rosângela Minardi Mitre Cotta ◽  
Luciana Saraiva da Silva
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Roc Curve ◽  
Care Service ◽  
Health Care Service ◽  
Creatinine Ratio ◽  
Cross Sectional ◽  
Hypertensive Patients

Abstract Background Recent studies have shown that the serum uric acid/creatinine ratio (SUA/SCr) is a better predictor of chronic kidney disease (CKD) than serum uric acid (SUA) isolated. The aim of the present study was to evaluate the association of isolated SUA and the SUA/SCr with CKD in hypertensive patients. Methods Cross-sectional study conducted with hypertensive patients followed-up by the Primary Health Care Service (PHC). Sociodemographic, economic, lifestyle, clinical, anthropometric, and biochemical variables were evaluated. The association between SUA parameters (quartiles of SUA and quartiles of SUA/SCr) and CKD was evaluated by bivariate and multivariate logistic regression. The association between SUA parameters (SUA and SUA/SCr) and estimated glomerular filtration rate (eGFR) was evaluated by linear regression. The analyses were performed considering four adjustment models. SUA and SUA/SCr were compared by receiver operating characteristic (ROC) curve. Results In the fully adjusted model, SUA was positively associated with the presence of CKD (OR = 6.72 [95 % CI 1.96–22.96]) and inversely associated with eGFR (β Coef. = -2.41 [95 % CI -3.44; -1.39]). SUA/SCr was positively associated with eGFR (β Coef. = 2.39 [1.42; 3.36]). According to the ROC curve, the SUA is a better predictor of CKD than the SUA/SCr. Conclusions Elevated levels of isolated SUA were associated with CKD and eGFR. However, the SUA/SCr was not associated with CKD. We do not recommend using the SUA/SCr to predict CKD in hypertensive patients.

scholarly journals The effect of hepcidin on components of metabolic syndrome in chronic kidney disease: a cross-sectional study

2020 ◽  
Vol 66 (8) ◽  
pp. 1100-1107
Author(s):  
Sibel Gökçay Bek ◽  
Berna Üstüner ◽  
Necmi Eren ◽  
Zeynep Sentürk ◽  
Betül Kalender Gönüllü
Keyword(s):  
Metabolic Syndrome ◽  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Cross Sectional Study ◽  
Renal Diseases ◽  
Sectional Study ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein

SUMMARY BACKGROUND Hepcidin is an important regulator of iron homeostasis. OBJECTIVES This cross-sectional study was conducted to evaluate the association between hepcidin and components of metabolic syndrome in patients with chronic kidney disease (CKD). DESIGN AND SETTING 103 CKD patients and 59 healthy volunteers were included in the study from the University Hospital. METHODS Serum hepcidin levels were measured by enyzme-linked immunosorbent assay (ELISA) test. As for the study parameters, age, sex, body mass index, renal diseases, serum biochemistry, complete blood count, iron and total iron-binding capacity, ferritin, high-sensitive C-reactive protein (hsCRP), C- reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated. RESULTS The mean age of the patients was 58.63 ± 11.8 years. Hepcidin level was significantly associated with hypertension and higher uric acid levels (P < 0.05). There was a positive correlation between hepcidin and urea, uric acid, creatinine, ferritin, CRP, ESR, phosphorus, triglyceride, low-density lipoprotein (LDL), proteinuria and albuminuria in 24-hour urine collection. A negative correlation was found between hepcidin and estimated glomerular filtration rate (eGFR), hemoglobin, hematocrit, calcium, 25 OH vitamin D, pH, and bicarbonate levels. CONCLUSION Hepcidin, a well-known hormone regulator of iron metabolism, may play an important role in the pathogenesis of metabolic syndrome in patients with CKD, and further studies might delineate in-depth its potential as a promising early marker in these patients.

scholarly journals PRE DIALYSIS PATIENTS;

2017 ◽  
Vol 24 (02) ◽  
pp. 267-272
Author(s):  
Syed Hidayet Ali ◽  
Bagwan Das ◽  
Agha Taj ◽  
Santosh Kumar ◽  
Besham Kumar
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Descriptive Analysis ◽  
Cross Sectional Study ◽  
P Value ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Reduced Body ◽  
Ckd Stage ◽  
Duration Of Disease

Introduction: Chronic kidney disease (CKD) is an alarmingly increasingcondition from day to day andit is assumed that malnutrition is co-existent in patients withchronic renal failure (CRF). Malnutrition also occurs in pre-dialysis patients. Such patientshave reduced body weight, depleted fat (energy) stores, loss of somatic protein (low musclemass) and low levels of different plasma proteins like pre-albumin albumin, transferrin, andothers. Objective: To ascertain the frequency of malnutrition in dialysis independent patientsof chronic kidney disease. Setting: Department of nephrology, Jinnah Postgraduate MedicalCentre Karachi. Duration of study: 6 month from 1 June 2013 – 1 December 2013. Studydesign: cross sectional study. Subjects and methods: Patients with chronic kidney disease(GFR <60ml/min/1.73m2) on conservative management irrespective of cause and sex werestudied. All Patients with CKD stage 3 and onwards i. ecreatinine clearance less than 60ml/min/1.73m2for more than 6 months were considered. Descriptive analysis of these patientswas done by: Calculating mean ± SD for age and duration of disease. Male to female ratiowas calculated. Frequency of malnutrition in undialysed patients was calculated. The effectmodifier of age, gender, duration of disease was controlled through stratification. Chi squaretest was applied and p value ≤0.05 was taken as significant. Result: Out of 137 patients, 80were males and 57 were females and the mean age of patients was 58 ±5.8. Mean duration ofdisease was 5.2 ±1.05. Moderate malnutrition cases were 58(42.3%) while severe malnutritionwas observed in 32(23.35%) cases. Conclusion: Patients of chronic kidney disease were foundto be at risk of malnutrition.

scholarly journals Prevalence of Diabetes Mellitus in Patients with Chronic Kidney Disease

2016 ◽  
Vol 4 (1) ◽  
pp. 79-82 ◽  
Author(s):  
Olivera Stojceva-Taneva ◽  
Natasa Eftimovska Otovic ◽  
Borjanka Taneva
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Republic Of Macedonia ◽  
Ckd Stage ◽  
The Republic ◽  
Prevalence Of Diabetes Mellitus

BACKGROUND: Chronic kidney disease (CKD) became a new epidemic of the twentieth and twenty-first centuries. Diabetic nephropathy is one of the leading causes of end-stage renal failure as a result of the diabetes epidemic worldwide.AIM: The aim of our study was to assess the prevalence of CKD in the Republic of Macedonia and its association with diabetes mellitus.MATERIALS AND METHODS: The study was a part of a study conducted in 2006 in terms of screening for early detection of kidney disease. It was a cross-sectional study based on a random sample of patients aged > 20, consecutively consulting their primary physician for any cause. Fifty physicians throughout the country were included in the study. A total of 2637 patients have been analyzed based on integrity data. GFR was estimated using corrected values of serum creatinine and calculating kidney function by the Cockroft & Gault formula, adjusted for body surface using the Gehan & George formula. Patients with estimated glomerular filtration rate (eGFR) less than 60 ml/min were considered as having CKD. Blood pressure, body weight, height, serum creatinine, glucose, hemoglobin, hematocrit, urinalysis and medical history for presence of cardiovascular diseases or diabetes were also assessed.RESULTS: The mean age of the subjects was 45.97 ± 16.55 SD and 17.97% were older than 60. Regarding gender, 44.14% were males. The prevalence of diabetes mellitus was 13.9%. Subjects with CKD (eGFR less than 60 ml/min) were 7.53% of the total. Subjects aged 60 or above, had 20 times higher risk of having CKD (eGFR less than 60 ml/min/1.73 m2). Out of the total group of subjects, 13.9% had diabetes mellitus and they had 3.13 times higher risk of having CKD stage 3-5 (eGFR less than 60 ml/min/1.73 m2) when compared to non-diabetics. The results showed that diabetes was significantly more associated with lower eGFR (less than 60 ml/min/1.73 m2) in younger subjects (age less than 60) compared to older ones (odds ratio 3.29 versus 1.21).CONCLUSION: Our study showed that chronic kidney disease is frequent in the Republic of Macedonia and is associated with older age and diabetes. Diabetes had a significantly stronger association with CKD at younger age.

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