Effect of treatment of hyperuricemia with allopurinol on blood pressure,creatinine clearence,and proteinuria in patients with normal renal functions |
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Authors: | Mehmet Kanbay Adem Ozkara Yusuf Selcoki Bunyamin Isik Faruk Turgut Nuket Bavbek Ebru Uz Ali Akcay Ramazan Yigitoglu Adrian Covic |
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Institution: | (1) 35. Sokak, 81/5, Bahcelievler, Ankara, 06490, Turkey;(2) Department of Internal Medicine, Section of Nephrology, Fatih University School of Medicine, Ankara, Turkey;(3) Department of Family Medicine, Fatih University School of Medicine, Ankara, Turkey;(4) Department of Cardiology, Fatih University School of Medicine, Ankara, Turkey;(5) Department of Biochemistry, Fatih University School of Medicine, Ankara, Turkey;(6) Department of Nephrology Clinic and Dialysis and Transplantation Center, “C. I. PARHON” University Hospital, Iasi, Romania |
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Abstract: | Background Hyperuricemia has been associated with the development of hypertension, cardiovascular, and renal disease. However, there
is no data about the effect of lowering uric acid level on hypertension, renal function, and proteinuria in patients with
glomerular filtration rate (GFR) >60 ml/min. We therefore conducted a prospective study to investigate the benefits of allopurinol
treatment in hyperuricemic patients with normal renal function.
Materials and methods Forty-eight hyperuricemic and 21 normouricemic patients were included in the study. Hyperuricemic patients received 300 mg/day
allopurinol for three months. All patients’ serum creatinine level, 24-h urine protein level, glomerular filtration rate,
and blood pressure levels were measured at baseline and after three months of treatment.
Results A total of 59 patients completed the three-month follow-up period of observation. In the allopurinol group, serum uric acid
levels, GFR, systolic and diastolic blood pressure, and C-reactive protein (CRP) levels significantly improved (P < 0.05). However, urine protein excretion remained unchanged (P > 0.05). No correlation was observed between changes in GFR and changes in CRP, or blood pressure in the allopurinol group.
No significant changes were observed in the control group (P > 0.05).
Conclusion We bring indirect evidence that hyperuricemia increases blood pressure, and decreases GFR. Hence, management of hyperuricemia
may prevent the progression of renal disease, even in patients with normal renal function, suggesting that early treatment
with allopurinol should be an important part of the management of chronic kidney disease (CKD) patients. Long-term follow-up
studies are warranted to identify the benefits of uric acid management on renal function and hypertension. |
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Keywords: | Uric acid Allopurinol Blood pressure Renal function Proteinuria |
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