Efficacy And Safety Of Different Dosages Of Febuxostat In Maintenance Peritoneal Dialysis Patients With Hyperuricemia

Objectives The aim of this study was to evaluate the efficacy and safety of different doses of Febuxostat in maintenance peritoneal dialysis patients with asymptomatic Hyperuricemia.Subjects and Methods This study was a single-center randomized,double-blind,dose-response controlled trial.fifty-seven Patients with peritoneal dialysis complicated with asymptomatic Hyperuricemia attending in Department of Nephrology of a hospital from January 2018 to December 2019.Sixty eligible peritoneal dialysis patients were randomly divided into two groups: Group A was given Febuxostat 20 mg/d,and Group B was given Febuxostat 40 mg/d.Serum uric acid(SUA)levels were measured at baseline and after 4 and 8 weeks of treatment,respectively,the serum alanine aminotransfease(ALT),serum creatinine(Scr),blood urea nitrogen(BUN)and other biochemical indicators were measured at baseline and at the end of the study,Serum alanine aminotransferase(ALT),serum aspartate aminotransferase(AST),and the occurrence of pancytopenia were tested as safety parameters at baseline and at the end of study.Results 1.After 4 weeks of treatment with febuxacin,the average SUA level in group A and group B was significantly improved compared with that before the treatment,with an average decrease of 110.51±27.06 in group A and 139.04± 14.50 in group B,and the difference before and after treatment was statistically significant(PA<0.001,PB<0.001).The difference between groups was statistically significant(P<0.05).2.After 8 weeks of treatment with febuxostat,the average SUA level in group A and group B was significantly lower than that before the treatment,with an average decrease of 56.30±21.2 in group A and 40.20±18.9 in group B,and the difference before and after treatment was statistically significant(PA<0.001,PB<0.001).There was no statistically significant difference between the groups(P=0.553,P>0.05).3.In terms of liver safety and blood routine,there was no statistically significant difference in blood routine indexes(hemoglobin,white blood cells,platelets)and liver function indexes(ALT,AST)before and after treatment in either the half-dose group or the conventional dose group(P >0.05).4.In terms of residual renal function,there was no significant difference in e GFR and 24 h urine volume before and after treatment with 20mg/d or 40mg/d non-bustatin in patients with PD complicated with asymptomatic hyperuricemia(SUA)(P>0.05).Conclusion 1.In the treatment of pd patients with asymptomatic hyperuricemia with low-dose febuxostat,serum uric acid level can be significantly reduced.2.Short-term medication(4 weeks)group A had worse effect than group B;The effect of long-term medication(8 weeks)on lowering uric acid in group A was basically the same as that in group B.3.The effects of different dosages of Febulistat on residual renal function were similar.4.Low dose febuxostat was a safe treatment for lowering uric acid without serious adverse events such as severe liver dysfunction,pancytopenia and thromboembolic heart disease.