Effect Of Urate-lowering Therapy On Renal Function In Chronic Kidney Disease Stages 2-5 Patients With Hyperuricemia

Objective :To investigate renal effect in stages 2-5 chronic kidney disease(CKD)patients with hyperuricemia(HUA)after urate-lowering therapy.Methods:We performed a 6-months prospective,self-controlled study of 132 patients who were recruited between July 2016 and December 2017.The levels of serum uric acid(SUA),e GFR and other biochemical parameters were detected at baseline and 1-6 months after treatment,the change in SUA and e GFR levels.The influential factors of renal function were analyzed.On the basis of original renal functional status,all patients were divided into group A(CKD stages 2-3a)and group B(CKD stages 3b-5).The difference of effect of urate-lowering therapy and renal function improvement between the two groups were analyzed.All patients were divided into the target group and the non-target group in the light of final SUA level,the renal function was compared between the two groups.Results :At month 1,3,6,the average SUA,SCr and urea nitrogen level of all patients decreased significantly(P?0.05,P?0.05,P?0.05),while e GFR had a significant rise(P ? 0.05).After six-month-therapy,proteinuriain and hematuria decreased significantly in all patients(P ? 0.001,P=0.001).The uric acid level of group A and group B dropped significantly(P?0.001,P<0.001)while e GFR had a significant rise after treatment(P?0.001).There was significant difference in e GFR level change between the two groups(P=0.044).The basic renal function was an influential factor of the increase of renal function after treatment(b=0.161,P=0.020).After six-month-therapy,the e GFR level of target group and non-target group were increased(P<0.001,P<0.001),and the difference between the two groups was statistically significant(P=0.021).Conclusions :The aggressive urate-lowering therapy can significantly improve the renal function of patients with CKD,which can effectively reduce proteinuria and hematuria.In all stages of CKD,urate-lowering therapy should be taken as quickly as possible,and the benefits of early intervention are greater.Urate-lowering therapy can provide CKD patients with further renal function improvement if the SUA achieves target level.