Long-term efficacy of hyperuricaemia treatment in renal transplant patients

Pérez-Ruiz, Fernando; Gómez-Ullate, P; Amenábar, Juan José; Zárraga, Sofía; Calabozo, M; Herrero-Beites, Ana María; Nolla, Joan M.

doi:10.1093/ndt/18.3.603

Cited by 43 publications

(15 citation statements)

References 12 publications

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“…Amlodipine may be useful in treatment of hypertension in hypertensive, hyperuricemic renal transplant patients. Benziodarone and allopurinol have been shown to be effective in controlling hyperuricemia in renal transplant patients, and benziodarone at greater than 75 mg per day is statistically significantly more effective than allopurinol [61].…”

Section: Fenofibrate Losartan and Amlodipinementioning

confidence: 99%

Serum uric acid-lowering therapies: Where are we heading in management of hyperuricemia and the potential role of uricase

Bomalaski

Clark²

2004

Curr Rheumatol Rep

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Although allopurinol has been available for approximately 50 years, hyperuricemia and its sequelae are not only prevalent, but the incidence and costs associated with this disorder continue to increase. However, several new therapies have been developed. Recombinant urate oxidase has been useful in the treatment of tumor lysis hyperuricemia, and pegylated urate oxidase shows promise in patients with hyperuricemia and gout. Febuxostat and Y-700 are new oral xanthine oxidase inhibitors that are in human clinical trials. Tailoring of antilipid therapy in selected hyperuricemic and hyperlipidemic patients with fenofibrate may be of benefit in lowering blood cholesterol and uric acid levels. Similarly, treatment of selected hyperuricemic patients who also are hypertensive with losartan or amlodipine may be beneficial in lowering blood pressure and hyperuricemia. Despite these advances, new treatments for hyperuricemia are needed.

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Section: Fenofibrate Losartan and Amlodipinementioning

confidence: 99%

Serum uric acid-lowering therapies: Where are we heading in management of hyperuricemia and the potential role of uricase

Bomalaski

Clark²

2004

Curr Rheumatol Rep

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“…Cyclosporine may decrease tubular secretion and increase proximal tubular reabsorption of uric acid. 16,18 In addition, calcineurin inhibitors may cause vasoconstriction of afferent arteries and lower GFR. Although it was previously believed that tacrolimus did not have hyperuricemic effects to the same extent as cyclosporine, a study showed no difference in uric acid levels between tacrolimus-and cyclosporinebased treatment at 24-month follow-up.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2014

Exp Clin Transplant

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Objectives: Hyperuricemia may be a risk factor for graft loss in kidney transplant recipients. The purpose of this study was to evaluate the effects of allopurinol in kidney transplant recipients. Materials and Methods: A single center retrospective case-control study was performed with kidney transplant recipients who were treated with allopurinol (54 patients) and a control group matched for time of transplant (± 3 months) and estimated glomerular filtration rate (54 patients). We evaluated the relation between allopurinol use and estimated glomerular filtration rate, graft survival, blood pressure, and number of antihypertensive drugs used. Results: At the start of allopurinol therapy, mean serum uric acid level was greater in the allopurinol (476 ± 119 μmol/L) than control group (404 ± 125 μmol/L; P ≤ .001) and estimated glomerular filtration rate was similar between the 2 groups (allopurinol, 39 ± 16 mL/min; control, 38 ± 16 mL/min; not significant). At 1 year, mean estimated glomerular filtration rate was greater in the allopurinol than control group (allopurinol, 41 ± 15 mL/min; control, 36 ± 13 mL/min; P ≤ .04). At 2 years, mean serum uric acid level was significantly lower in the allopurinol (399 ± 101 μmol/L) than control group (452 ± 95 μmol/L; P ≤ .02). Graft survival, blood pressure, and antihypertensive requirements were similar between the groups. Conclusions: Allopurinol use is associated with preservation of estimated glomerular filtration rate in kidney transplant recipients. There may be potential benefit in treating asymptomatic hyperuricemia in kidney transplant recipients.

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“…Since the metabolism of azathioprine is partly dependent on xanthine oxidase, coadministration of these drugs results in an increased risk of severe bone marrow toxicity. Therefore, some treatment protocols avoid this combination [10]. If, however, azathioprine and allopurinol are co-administered, the dose of the former has to be reduced by approximately 50%, and careful monitoring of blood cell counts is mandatory.…”

Section: Discussionmentioning

confidence: 99%

Gout in pediatric renal transplant recipients

et al. 2010

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Clinical gout has rarely been described after pediatric renal transplantation (RTx), although asymptomatic hyperuricemia is common in these patients. We describe three male pediatric patients who presented with gouty arthritis 7-8.5 years following RTx. Since receiving allopurinol, all patients had been free of gouty symptoms. To prevent severe bone marrow depletion, the dosage of azathioprine, an immunosupressant drug, was reduced by 50% to prevent interaction with allopurinol. Because atypical presentation of gout can occur, a high index of suspicion is needed to allow appropriate diagnosis of this disease in patients with skeletal pain after RTx.

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Long-term efficacy of hyperuricaemia treatment in renal transplant patients

Abstract: Both allopurinol and benziodarone were effective for the control of hyperuricaemia in renal transplantation. Benziodarone at doses >75 mg/day was more effective than allopurinol in reducing serum uric acid levels and also reduced the risk of azathioprine-allopurinol interactions.

Cited by 43 publications

References 12 publications

Serum uric acid-lowering therapies: Where are we heading in management of hyperuricemia and the potential role of uricase

Serum uric acid-lowering therapies: Where are we heading in management of hyperuricemia and the potential role of uricase

Untitled

Gout in pediatric renal transplant recipients

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