Multicenter randomized controlled trial of intensive uric acid lowering therapy for CKD patients with hyperuricemia: TARGET-UA.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY

Clinical and Experimental Nephrology Pub Date : 2024-08-01 Epub Date: 2024-03-26 DOI:10.1007/s10157-024-02483-w

Tetsuya Yamamoto, Masato Kasahara, Kenji Ueshima, Shiro Uemura, Naoki Kashihara, Kenjiro Kimura, Tsuneo Konta, Tetsuo Shoji, Akira Mima, Masashi Mukoyama, Yoshihiko Saito

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引用次数: 0

Abstract

Background: We investigate whether Intensive uric acid (UA)-lowering therapy (ULT) provides increased renal protection compared with standard therapy in chronic kidney disease (CKD) patients.

Methods: This was a multicenter randomized controlled trial. Only CKD patients with hyperuricemia were included in this study. The participants were randomly assigned to either the Intensive therapy group (target serum UA level ≥ 4.0 mg/dL and < 5.0 mg/dL) or the standard therapy group (serum UA level ≥ 6.0 mg/dL and < 7.0 mg/dL). ULT was performed using topiroxostat, a non-purine-type selective xanthine oxidase inhibitor. The primary endpoint was change in the logarithmic value of urine albumin to the creatinine ratio (ACR) between baseline and week 52 of the treatment.

Results: Three hundred fifty-two patients were included in the full analysis set. In the Standard therapy group, mean serum UA was 8.23 mg/dL at baseline and 6.13 mg/dL at 52 weeks. In the Intensive therapy group, mean serum UA was 8.15 mg/dL at baseline and 5.25 mg/dL at 52 weeks. There was no significant difference in changes in log ACR at 52 weeks between the Intensive therapy and the Standard therapy groups.

Conclusion: This study did not reveal the benefit of Intensive ULT to improve albuminuria levels. (UMIN000026741 and jRCTs051180146).

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针对高尿酸血症 CKD 患者的强化降尿酸治疗多中心随机对照试验：TARGET-UA.

背景：我们研究了与标准疗法相比，强化降尿酸疗法（ULT）是否能增强慢性肾脏病（CKD）患者的肾脏保护：这是一项多中心随机对照试验。方法：这是一项多中心随机对照试验，只有患有高尿酸血症的 CKD 患者才被纳入研究范围。参与者被随机分配到强化治疗组（目标血清尿酸水平≥ 4.0 毫克/分升）和结果组（目标血清尿酸水平≥ 4.0 毫克/分升）：共有 352 名患者被纳入完整的分析组。在标准疗法组中，基线时的平均血清尿酸为 8.23 毫克/分升，52 周时为 6.13 毫克/分升。在强化治疗组中，基线时的平均血清尿酸为 8.15 毫克/分升，52 周时为 5.25 毫克/分升。强化治疗组和标准治疗组在 52 周时的 ACR 对数变化无明显差异：本研究并未显示强化超短波疗法对改善白蛋白尿水平有益处。(UMIN000026741和jRCTs051180146）。

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.