期刊
KIDNEY & BLOOD PRESSURE RESEARCH
卷 35, 期 3, 页码 153-160出版社
KARGER
DOI: 10.1159/000331453
关键词
Hyperuricemia; IgA nephropathy; Prognosis; Outcome
资金
- Scientific and Technologic Committee of Guangdong Province [2006A36001002, 2005B30701002]
- Guangdong Province Health Office [A2005189]
- Guangdong Natural Science Foundation [6021368]
- ISN
- Sun Yat-sen University
- Guangdong province university academic and discipline development [2010-76]
- 973 project [2011CB50400050]
- NIH [HL-68607, DK-52121]
Background: Hyperuricemia is an independent risk factor for renal progression in IgA nephropathy (IgAN). However, no study has evaluated the effect of allopurinol on the clinical outcome in hyperuricemic IgAN. Methods: First, a retrospective cohort study of 353 IgAN patients was conducted to explore the relationship between uric acid (UA) and the progression of renal disease over a mean period of 5 years. Then, 40 hyperuricemic IgAN patients were randomized to receive allopurinol (100-300 mg/day) or usual therapy for 6 months. The study outcomes were renal disease progression and/or blood pressure. Results: Hyperuricemia independently predicted renal survival at 1, 3, and 5 years after adjustment for different baseline estimated glomerular filtration rates. In the randomized controlled trial, allopurinol did not significantly alter renal progression or proteinuria. The antihypertensive drug dosage was reduced in 7 of 9 cases with hypertension in the allopurinol group compared to 0 of 9 cases in the control group (p < 0.01). UA levels correlated with mean arterial pressure in normotensive patients (r = 0.388, p < 0.001). Conclusion: Hyperuricemia predicts the progression of IgAN independently of baseline estimated glomerular filtration rate. Allopurinol may improve the control of blood pressure. Further studies are required to explore the effects of lowering UA on renal protection in IgAN. Copyright (C) 2011 S. Karger AG, Basel
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