Allopurinol and kidney function: An update

Stamp, Lisa K.; Chapman, Peter T.; Palmer, Suetonia C.

doi:10.1016/j.jbspin.2015.03.013

Cited by 37 publications

(22 citation statements)

References 49 publications

(55 reference statements)

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“…As a result, more studies are required in order to understand this phenomenon as reflected in the comments of Stamp et al . 99 .…”

Section: Discussionmentioning

confidence: 99%

Risk of Kidney Dysfunction from Polypharmacy among Older Patients: A Nested Case-Control Study of the South Korean Senior Cohort

Kang

Hong

2019

Sci Rep

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Polypharmacy, the concurrent use of multiple medicines, could increase the risk of kidney dysfunction among older adults because it likely burdens the aging kidneys to excrete multiple pharmaceutical ingredients and their metabolites. This study aimed to examine the relation between polypharmacy and kidney dysfunction among older patients. A nested case-control study was conducted using the National Health Insurance Service – Senior Cohort (NHIS-SC, 2009–2013), representative of the Korean senior population. It consisted of all health insurance claims linked to records of mandatory health examination. Kidney dysfunction was defined as having an eGFR lower than 60, with a decline rate of 10% or more compared to the baseline eGFR. Polypharmacy was defined based on daily counts of pharmaceutical ingredients during one year prior to the case’s event date. It was classified into polypharmacy (five to 10 ingredients) and excessive polypharmacy (10 or more ingredients). After matching case and control groups based on a range of potential confounders, conditional logistic regression was performed incorporating adjustments on disease-specific, medication-specific, and lifestyle-related risk factors. The matching resulted in 14,577 pairs of cases and controls. Exposure to polypharmacy was significantly associated with increase in the risk of kidney dysfunction; i.e., crude model (polypharmacy: OR = 1.572, 95% CI = 1.492–1.656; excessive polypharmacy: OR = 2.069, 95% CI = 1.876–2.283) and risk adjustment model (polypharmacy: OR = 1.213, 95% CI = 1.139–1.292; excessive polypharmacy: OR = 1.461, 95% CI = 1.303–1.639). The significant associations were robust across different definitions of kidney dysfunction. These findings inform healthcare providers and policy makers of the importance of polypharmacy prevention to protect older adults from kidney dysfunction.

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“…As a result, more studies are required in order to understand this phenomenon as reflected in the comments of Stamp et al . 99 .…”

Section: Discussionmentioning

confidence: 99%

Risk of Kidney Dysfunction from Polypharmacy among Older Patients: A Nested Case-Control Study of the South Korean Senior Cohort

Kang

Hong

2019

Sci Rep

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“…Meanwhile, its safety in pregnancy has been debated due to reports on possible teratogenicity [111]. In addition, allopurinol may cause some side effects, such as renal stones and neurological disorders, due to xanthine and hypoxanthine accumulation [112].…”

Section: Xanthine Oxidase Inhibition Studiesmentioning

confidence: 99%

The Role of Oxidative Stress in Hyperuricemia and Xanthine Oxidoreductase (XOR) Inhibitors

Liu

Sun

et al. 2021

Oxidative Medicine and Cellular Longevity

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Uric acid is the end product of purine metabolism in humans. Hyperuricemia is a metabolic disease caused by the increased formation or reduced excretion of serum uric acid (SUA). Alterations in SUA homeostasis have been linked to a number of diseases, and hyperuricemia is the major etiologic factor of gout and has been correlated with metabolic syndrome, cardiovascular disease, diabetes, hypertension, and renal disease. Oxidative stress is usually defined as an imbalance between free radicals and antioxidants in our body and is considered to be one of the main causes of cell damage and the development of disease. Studies have demonstrated that hyperuricemia is closely related to the generation of reactive oxygen species (ROS). In the human body, xanthine oxidoreductase (XOR) catalyzes the oxidative hydroxylation of hypoxanthine to xanthine to uric acid, with the accompanying production of ROS. Therefore, XOR is considered a drug target for the treatment of hyperuricemia and gout. In this review, we discuss the mechanisms of uric acid transport and the development of hyperuricemia, emphasizing the role of oxidative stress in the occurrence and development of hyperuricemia. We also summarize recent advances and new discoveries in XOR inhibitors.

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“…Amongst them, allopurinol, an XO inhibitor, is the most frequently prescribed agent for gout in the United States [ 10 ]. Unfortunately, the majority of patients treated with allopurinol do not achieve target SUA levels, possibly due to an intolerance to allopurinol at doses ≥ 300 mg dose and the need for reduced doses in patients with renal insufficiency [ 11 ]. It is therefore recommended to initially evaluate renal function in gout patients with CKD [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Multiple-Purpose Connectivity Map Analysis Reveals the Benefits of Esculetin to Hyperuricemia and Renal Fibrosis

Wang

Zhu

Wang

et al. 2020

IJMS

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Hyperuricemia (HUA) is a risk factor for chronic kidney disease (CKD). Serum uric acid (SUA) levels in CKD stage 3–4 patients closely correlate with hyperuricemic nephropathy (HN) morbidity. New uric acid (UA)-lowering strategies are required to prevent CKD. The multiple-purpose connectivity map (CMAP) was used to discover potential molecules against HUA and renal fibrosis. We used HUA and unilateral ureteral occlusion (UUO) model mice to verify renoprotective effects of molecules and explore related mechanisms. In vitro experiments were performed in HepG2 and NRK-52E cells induced by UA. Esculetin was the top scoring compound and lowered serum uric acid (SUA) levels with dual functions on UA excretion. Esculetin exerted these effects by inhibiting expression and activity of xanthine oxidase (XO) in liver, and modulating UA transporters in kidney. The mechanism by which esculetin suppressed XO was related to inhibiting the nuclear translocation of hexokinase 2 (HK2). Esculetin was anti-fibrotic in HUA and UUO mice through inhibiting TGF-β1-activated profibrotic signals. The renoprotection effects of esculetin in HUA mice were associated with lower SUA, alleviation of oxidative stress, and inhibition of fibrosis. Esculetin is a candidate urate-lowering drug with renoprotective activity and the ability to inhibit XO, promote excretion of UA, protect oxidative stress injury, and reduce renal fibrosis.

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Allopurinol and kidney function: An update

Cited by 37 publications

References 49 publications

Risk of Kidney Dysfunction from Polypharmacy among Older Patients: A Nested Case-Control Study of the South Korean Senior Cohort

Risk of Kidney Dysfunction from Polypharmacy among Older Patients: A Nested Case-Control Study of the South Korean Senior Cohort

The Role of Oxidative Stress in Hyperuricemia and Xanthine Oxidoreductase (XOR) Inhibitors

Multiple-Purpose Connectivity Map Analysis Reveals the Benefits of Esculetin to Hyperuricemia and Renal Fibrosis

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