Efficacy and influencing factors of febuxostat in treating chronic kidney disease patients with hyperuricemia
Ren Ying
Li Dan-dan
Luo Xiao-qin
Abstract：Objective To investigate the efficacy of febuxostat in the treatment of patients with chronic kidney disease com-plicated with hyperuricemia and to analyze the influencing factors of the efficacy.Methods The clinical data of 105 patients with chronic kidney disease and hyperuricemia treated in Mianzhu People's Hospital from January 2021 to March 2024 were retrospec-tively collected.According to the different therapeutic drugs,they were divided into the treatment group(n=67,oral febuxostat)and control group(n=38,oral allopurinol).The efficacy of the drugs was compared between the two groups.According to serum uric acid level 6 months after febuxostat treatment,they were classified into 46 cases in good control group(serum uric acid<360 μmol·L-1)and 21 cases in poor control group(serum uric acid≥360 μmol·L-1).Multivariate Logistic regression analysis was used to analyze the related factors affecting the therapeutic effect of febuxostat in patients with chronic kidney disease complicated with hyperuri-cemia.Results The total effective rate of treatment in the treatment group was 92.54%(62/67),which was higher than that in the control(78.95%,30/38),and the difference was statistically significant(χ2=4.128,P<0.05).After treatment,the levels of serum uric acid and serum creatinine(Scr)were(329.28±31.45)µmol·L-1 and(162.75±14.16)µmol·L-1 in treatment group and they were lower than(355.06±40.17)µmol·L-1 and(185.03±17.76)µmol·L-1 in the control group while the glomerular filtration rate(eGFR)level and good control rate of serum uric acid with(41.21±7.69)mL·min-1 and 68.66%(46/67)were higher than(37.43±5.57)mL·min-1 and 28.95%(11/38)in the control group,showing statistical differences(t=3.644,7.056,2.658,χ2=15.407,P<0.05).The propor-tions of patients with gout history,drinking history,hypertension and chronic kidney disease stage 4 and levels of Scr,blood urea nitrogen(BUN)and 24 h urine protein before treatment in poor serum uric acid control group with 80.95%(17/21),71.43%(15/21),66.67%(14/21),80.95%(17/21),(208.09±20.47)µmol·L-1,(16.14±3.32)mmol·L-1 and(2.39±0.41)g were higher than 39.13%(18/46),43.48%(20/46),34.78%(16/46),32.61%(15/46),(190.54±18.35)µmol·L-1,(10.08±2.29)mmol·L-1 and(1.72±0.45)g in good serum uric acid control group while the level of eGFR before treatment with(29.84±1.12)mL·min-1 was lower than(31.57±2.20)mL·min-1 in good serum uric acid control group,and the differences were statistically significant(χ2=10.107,4.514,5.928,13.506,t=3.502,8.683,5.807,3.398,P<0.05).Further Logistic regression analysis revealed that chronic kidney disease stage 4,history of gout,history of alcohol consumption,and pre-treatment levels of eGFR<30 mL·min-1(low level),Scr>180 µmol·L-1(high level),BUN>10 mmol·L-1(high level),and 24 h urine protein>1.5 g(high level)were independent risk factors for poor efficacy of febuxostat in patients with chronic kidney disease and hyperuricemia,demonstrating statistically significant differences(P<0.05).Conclusion Febuxostat can achieve a good therapeutic effect in patients with chronic kidney disease complicated with hyperuri-cemia,but a history of gout,a history of alcohol consumption,chronic kidney disease stage 4,eGFR<30 mL·min-1(low level),Scr>180 µmol·L-1(high level),BUN>10 mmol·L-1(high level),and 24 h urine protein>1.5 g(high level)will affect its therapeutic effect.
Keywords：FebuxostatChronic kidney diseaseHyperuricemiaEfficacyInfluencing factor
Publication Date：2025-04-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 215-219 )