Effect of different doses of febuxostat on uric acid control and oxidative stress response in chronic kidney disease patients

Li Li; Guo Siyu; Guo Ni

doi:10.3969/j.issn.1674-3245.2025.03.003

Abstract：Objective To observe the effects of different doses of febuxostat on patients with chronic kidney disease(CKD)stages 3-5 complicated by asymptomatic hyperuricemia.Methods 104 CKD patients with hyperuricemia were randomly divided into a febuxostat A group(n=52)and a febuxostat B group(n=52).The initial dose of febuxostat in Group A was 40 mg/day,and the dose was reduced to 20 mg/day when uric acid was below 360 μmol/L.The dose in Group B was 20 mg/day,and no dose adjustment was made during the observation period.Both groups were observed continuously for 6 months.Record the uric acid compliance rate every month.Compare eGFR at 1,3,and 6 months of treatment,as well as levels of serum uric acid,malondialdehyde(MDA)and superoxide dismutase(SOD)at 1,2,3,and 6 months of treatment,and record the occurrence of adverse reactions.Results At the end of the first month,the uric acid compliance rate in Group A was 77.55％,which was higher than that in Group B(58.82％)(x2=4.028,P=0.045).There was no statistically significant difference in the compliance rate between the two groups at the end of the 2nd to 6th months.The serum uric acid levels at the end of 1 month and 2 months in Group A were(392.5±40.2)μmuol/L and(373.8±32.7)μmol/L,respectively,which were lower than those in Group B[(418.6±31.4)μmol/L and(391.4±25.8)μmol/L](P＜0.05).while at 3 to 6 months,there was no statistically significant difference in blood uric acid between the two groups(P＞0.05).After 1,2,3,and 6 months of treatment,the MDA levels in both groups decreased,while the SOD levels increased,with statistically significant differences compared to the time of enrollment.At 1 and 2 months of treatment,the SOD levels in group B were(105.2±12.9)U/ml and(110.4±9.7)U/ml,which were lower than those in group A of(118.3±14.5)U/ml and(116.9±17.1)U/ml(t=4.741,2.349,P＜0.05).There was no statistically significant difference in eGFR between the two groups at 1,3,and 6 months(P＞0.05).The total incidence of adverse reactions in group A was slightly higher than that in group B,while the difference was not statistically significant(P＞0.05).Conclusion For CKD stage 3-5 non dialysis patients with hyperuricemia,febuxostat can effectively reduce blood uric acid levels and alleviate oxidative stress reactions.