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    Zhdan V.N., Tkachenko M.V., Babanina M.Yu., Volchenko G.V. , Kitura Ye.M.


    About the author: Zhdan V.N., Tkachenko M.V., Babanina M.Yu., Volchenko G.V. , Kitura Ye.M.
    Type of article Scentific article
    Annotation Hyperuricemia is associated with the development of gout, arterial hypertension and chronic kidney disease. The influence of allopurinol and hypo-uremic therapy on renal function has not been adequately studied, especially in patients with chronic kidney disease who are at increased risk of developing hypersensitivity reactions. The purpose of this study was to determine the effect of allopurinol on the functional capacity of the kidneys in patients with hyperuricemia. This is a retrospective study of a cohort of patients undergoing treatment on the basis of the rheumatologic department and the polyclinics of the Poltava Regional Clinical Hospital. M.V. Sklifosovsky using clinical, pharmacological and laboratory data. Retrospective analysis was conducted from October 2015 to September 2017. The study involved 40 patients with hyperuricemia, which was determined by an increasing in serum uric acid levels higher than 380 mmol / l (an average of ~ 500 mmol / l) who had recently begun therapy with allopurinol for any reason with a verified response to treatment. The comparison group consisted of 40 patients with hyperuricemia without a clinical manifestation who were not treated with allopurinol. All patients were divided by age, sex and glomerular filtration rate (GFR). Patients receiving allopurinol at an average dose of 250 mg / day (SD, 78) showed an increase in GFR of 11.8 ml / min (95% confidence interval, a dose of 4.7-11.8 mg / day , P = 0.01) than in the control group. It was found that the treatment effect depended on the baseline level of GFR, which is evidenced by a more significant therapeutic effect in patients with lower baseline GFR (P = 0.004). In the allopurinol treatment group, the lower endpoint of creatinine was 0.12 mg / dL (95% confidence interval, 0.003-0.20 mg / dl, P = 0.04) than in the control group of patients at baseline creatinine and age. Among the patients studied, two cases of adverse events were reported. Treatment of patients with hyperuricemia with allopurinol with an average duration of 15 months has led to a significant improvement in renal function in a cohort of men with hyperuricemia. Clinicians should take into account the potential benefits of allopurinol in the treatment of patients with hyperuricemia, especially those who need support and control of kidney function.
    Tags hyperuricemia, renal function, allopurinol
    • Zhdan VM, Kitura OYe, Kitura YeM, Babanina MYu, Tkachenko MV. Hiperurykemiya i arterialna hipertenziya u zahalnolikarskiy praktytsi. Simeyna medytsyna. 2015;4 (60):48-50. [in Ukrainian]
    • Kondratyuk VYe, Tarasenko OM. Hiperurykemiya ta podahra: suchasnyy stan problemy. Ukrayinskyy revmatolohichnyy zhurnal. 2016;65(3):30-37. [in Ukrainian]
    • Tkachenko MV. Hipourykemichna terapiya dlya profilaktyky ta likuvannya podahry: aktualnyy stan problemy. Svit medytsyny ta biolohiyi. 2017;4(62):197-203. [in Ukrainian]
    • Kuo CF, See LC, Yu KH, Chou IJ, Chiou MJ, Luo SF. Significance of serum uric acid levels on the risk of all cause and cardiovascular mortality. Rheumatology (Oxford). 2013; 52: 127-134.
    • Richette P, Doherty M, Pascual E, Barskova V, Becce F, Castaneda-Sabnabria J et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann. Rheum. Dis. 2017; 76:29-42.
    • Shiozawa A, Szabo SM, Bolzani A, Cheung A, Choi HK. Serum uric acid and the risk of incident and recurrent gout: a systematic review. J Rheumatol. 2017; https://doi.org/10.3899/jrheum.160452.
    • Stamp LK, O'Donnell JL, Zhang M, James J, Frampton C, Barclay ML, et al. Using allopurinol above the dose based on creatinine clearance is effective and safe in patients with chronic gout, including those with renal impairment. Arthritis Rheum. 2011;63:412-421.
    • Stamp LK, Taylor WJ, Jones PB, Dockerty JL, Drake J, Frampton C, et al. Starting dose is a risk factor for allopurinol hypersensitivity syndrome: a proposed safe starting dose of allopurinol. Arthritis Rheum. 2012;64:2529-2536.
    • Wright DF, Doogue MP, Barclay ML, Chapman PT, Cross NB, Irvine JH, et al. A population pharmacokinetic model to predict oxypurinol exposure in patients on haemodialysis. Eur J Clin Pharmacol. 2016;73:71-78. [PubMed]
    • Wright DF, Duffull SB, Merriman TR, Dalbeth N, Barclay ML, Stamp LK. Predicting allopurinol response in patients with gout. Br J Clin Pharmacol. 2016;81:277-289.
    • Zandman-Goddard G, Amital H, Shamrayevsky N, Raz R, Shalev V, Chodick G. Rates of adherence and persistence with allopurinol therapy among gout patients in Israel. Rheumatology (Oxford). 2013;52:1126-1131.
    Publication of the article «World of Medicine and Biology» №1(67), 2019 year, 051-055 pages, index UDK 616.61-03
    DOI 10.26724/2079-8334-2019-1-67-51