非布司他治疗慢性肾脏病4～5期合并高尿酸血症的有效性及安全性观察

Research on the efficacy and safety of febuxostat in chronic kidney disease of stage 4～5 patients with hyperuricemia

目的探讨非布司他治疗慢性肾脏病4-5期合并高尿酸血症的安全性及有效性。方法选取在我院肾内科就诊和治疗的10例慢性肾脏病4-5期合并高尿酸血症患者,给予非布司他20 mg/d治疗4周,比较治疗前后患者的尿酸水平及血肌酐、血尿素氮水平,估算肾小球滤过率变化,并观察药物的不良反应,评价上述患者接受非布司他治疗的有效性及安全性。结果接受非布司他治疗后,10例患者血尿酸水平均显著下降（P〈0.01）;血肌酐及血尿素氮水平下降,估算肾小球滤过率有升高趋势,但与治疗前比较,差异均无统计学意义。所有受试者均未见有痛风发作,未出现胃肠道反应、白细胞计数下降和肝功能异常等不良反应。结论对于慢性肾脏病4-5期合并高尿酸血症患者,接受低剂量非布司他较短时间治疗即可获得良好的降血尿酸效果,同时安全性较好。

Objective To investigate the efficacy and safety of febuxostat in chronic kidney disease of stage 4-5 （CKD 4-5） patients with hyperuricemia. Methods Ten cases CKD 4-5 patients combined with hyperuricemia were enrolled in this study. These patients were treated with febuxostat 20 mg/d for 4 weeks. Compared the changes of serum creatinine, blood urea, blood uric acid and estimated glomerular filtration rate before and after treatment. Results After treatment, the blood uric acid was decrease significantly （P 〈 0.01）. The serum creatinine and blood urea were decreased as well, while the estimated glomerular filtration rate in most of the patients was increased, but there was no significant difference （P 〉 0.05）. All patients had no gout flaring, gastrointestinal reaction, white blood cells decrease, abnormal liver function or other obvious side effects. Conclusion Low dose febuxostat can decrease blood uric acid level in CKD 4-5 patients combined with hyperurieemia.