Effect of allopurinol on the glomerular filtration rate of children with chronic kidney disease.

Background: Hyperuricemia is a leading risk factor for the development of chronic kidney disease (CKD). We hypothesized that lowering serum uric acid (SUA) with allopurinol in hyperuricemic children with CKD may reduce the risk of CKD progression.Methods: A total of 70 children, aged 3-15 years, wit...

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Publicado en:Pediatric Nephrology Vol. 33; no. 8; pp. 1405 - 1410
Autores principales: Ghane Sharbaf, Fatemeh, Assadi, Farahnak
Formato: research tables/charts randomized controlled trial Journal Article
Publicado: Springer Nature Aug2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2018
      vid: 33
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00467-018-3943-1
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        atl: Effect of allopurinol on the glomerular filtration rate of children with chronic kidney disease.
      aug:
        au:
          Ghane Sharbaf, Fatemeh
          Assadi, Farahnak
        affil: Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
      sug:
        subj:
          Disease Progression Prevention and Control
          Renal Insufficiency, Chronic Prevention and Control
          Glomerular Filtration Rate
          Allopurinol Therapeutic Use
          Hyperuricemia Drug Therapy
          Uric Acid Blood
          Human
          Child, Preschool
          Child
          Adolescence
          Prospective Studies
          Randomized Controlled Trials
          Body Mass Index
          C-Reactive Protein
          Multiple Regression
          Blood Pressure Determination
          Physical Examination
          Treatment Outcomes
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
      ab: Background: Hyperuricemia is a leading risk factor for the development of chronic kidney disease (CKD). We hypothesized that lowering serum uric acid (SUA) with allopurinol in hyperuricemic children with CKD may reduce the risk of CKD progression.Methods: A total of 70 children, aged 3-15 years, with elevated serum uric acid level (SUA) > 5.5 mg/dL and CKD stages 1-3 were prospectively randomized to receive allopurinol 5 mg/kg/day (study group, n = 38) or no treatment (control group, n = 32) for 4 months. The primary and secondary outcomes were changes in estimated glomerular filtration rate (eGFR) (> 10 mL/min/1.73m2) and the SUA (> 1.0 mg/dL) from baseline values, respectively.Results: Baseline age, gender, blood pressure (BP), body mass index (BMI), SUA, high-sensitive C-reactive protein (hsCRP), and eGFR were similar in allopurinol and control subjects. Allopurinol treatment resulted in a decrease in SUA, a decrease in systolic and diastolic BP, a decrease in hsCRP, and an increase in eGFR compared with the baseline values (p < 0.05 for all). No significant difference was observed in the control hyperuricemic subjects. In multiple regression analysis after incorporating variables (age, gender, BMI, systolic and diastolic BP, CRP, and SUA), eGFR was independently related to SUA both before and after treatments (p = 0.03 vs. p = 0.02, respectively). All patients in the study group tolerated allopurinol, and there were no adverse reactions observed by physical examination or reported by patients.Conclusion: Urate-lowering therapy with allopurinol, over a 4-month period, can improve renal function in children with CKD stages 1-3.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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