Archives of Renal Diseases and Management

Uric Acid appears to be one of the most important prognostic markers and one of the principal risk factors for cardiovascular diseases. The aim of our study was to assess three groups of patients: a fi rst group treated with Allopurinol (AL), a second group not adequately controlled by treatment with AL or allergic to AL switched to treatment with Febuxostat (AL/FB) and a third group of naive patients immediately treated with Febuxostat (FB). The effectiveness and tolerability of both drugs were therefore assessed over time. Materials and methods: 44 patients, with CKD in conservative therapy, were divided into 3 groups. A group of 20 patients (AL) with well controlled uricemic values (serum uric acid < 6 mg/dl); a group of 12 patients (AL/FB) with not well controlled uricemic values (serum uric acid concentration > 6.0 mg / dl) and / or intolerant to AL that were switched to treatment with FB, then a group of 12 naive patients (FB) treated immediately with FB. At time 0,3,6,9,12,18,24 months, all patients were monitored as regards: serum uric acid, renal function parameters, serum electrolytes, hemoglobin, lipid profi le, blood glucose, glycated hemoglobin, proteinuria 24 hours,parathyroid hormone (PTH), C Reactive Protein (CRP). The doses of antiuric acid administered drug were also evaluated. All the patients underwent a monitoring of blood pressure (BP), heart rate (HR) and body mass index (BMI). Results: Patients treated with AL started with serum creatinine values signifi cantly lower, compared to patients of the two groups in FB, maintaining similar values for the entire period of observation. The glomerular fi ltration rate calculated using the CKD-EPI formula confi rmed the behaviour. Serum uric acid was signifi cantly lower (at 3 months p <0.003 and at 12 months p <0.001) in AL/FB group and FB group, compared to AL group. In addition, hyperuricaemia fell to values lower than 5mg / dl within 3 months of starting therapy with FB, while AL values remained around 6 mg / dl.Serum PTH showed no signifi cant changes in any group. Serum CRP was more controlled in the two groups treated with FB, while AL values were always higher (at 3 months p <0.003). Two patients resulted also intolerant to FB as well as to AL. The instrumental and clinical examinations revealed no alterations in any group. Conclusions: Considering our data, Febuxostat, represents a valuable therapeutic approach, especially in controlling serum uric acid values (better < 5.5 mg /dl) and infl ammatory markers (C Reactive Protein) of the patients with impaired renal function (CKD 3b-4). Research Article Effectiveness and Tolerability of Febuxostat vs Allopurinol in patients with Chronic Kidney Disease (CKD) on Conservative Therapy Filomena Panza, Chiara Ralli and Ennio Duranti* UOC Nephrology and Dialysis Unit, Hospital of Arezzo, Italy Dates: Received: 29 May, 2017; Accepted: 15 June, 2017; Published: 19 June, 2017 *Corresponding author: Ennio Duranti, UOC Nephrology and Dialysis Unit, Hospital of Arezzo, Italy, E-mail: https://www.peertechz.com