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allopurinol in dialysis

Estella Yeo, Suetonia C Palmer, Peter T Chapman, Christopher Frampton, Lisa K Stamp
BACKGROUND: To estimate the point prevalence of gout, gout treatment, and achievement of target serum urate (SU) among adults treated with long-term dialysis. METHODS: Three secular cohorts of adults receiving dialysis for at least 90 days on 1st February 2017, 1st January 2016 and 1st January 2015 were identified. Medical records were reviewed for SU concentrations. Results were compared between haemodialysis (HD) and peritoneal dialysis (PD), and participants prescribed and not prescribed urate-lowering therapy...
November 13, 2018: Internal Medicine Journal
Benjamin Cochran, Tereza Kovačíková, Kateřina Hodaňová, Martina Živná, Aleš Hnízda, Angela G Niehaus, Alex Bonnecaze, Gowrie Balasubraminiam, Irene Ceballos-Picot, Amret Hawfield, Kendrah Kidd, Stanislav Kmoch, Anthony J Bleyer
Adenine phosphoribosyltransferase (APRT) deficiency (OMIM #614723) is a rare autosomal recessive defect in the purine salvage pathway that causes excessive production of 2,8-dihydroxyadenine, leading to nephrolithiasis and chronic kidney disease (CKD). This case report describes the natural history of CKD in untreated APRT deficiency. We describe a novel APRT mutation (chr16:88877985 G / C; c.195 C>/G; p.His54Asp) presenting with CKD without nephrolithiasis. The patient initially required dialysis, but kidney function improved with allopurinol...
October 2018: Clinical Nephrology
Gad Baneth, Gilad Segev, Michal Mazaki-Tovi, Hila Chen, Sharon Kuzi
BACKGROUND: Renal disease is considered the main cause of natural mortality in dogs with canine leishmaniosis. The pathological mechanisms associated with kidney injury in canine leishmaniosis include immune complex glomerulonephritis, tubulointerstitial nephritis and occasionally renal amyloidosis. Proteinuria is a frequent finding in canine leishmaniosis and its quantification by the urine protein-creatinine ratio (UPC) is an important parameter in the staging of canine lesihmaniosis as presented by the LeishVet group...
March 20, 2018: Parasites & Vectors
Yume Nagaoka, Yoshiko Tanaka, Hiroshi Yoshimoto, Rie Suzuki, Kakei Ryu, Mio Ueda, Minako Akiyama, Miho Nagai, Yoshitaka Miyaoka, Eiichiro Kanda, Shinnichi Iwai, Michio Nagaoka, Yoshihiko Kanno
INTRODUCTION: Topiroxostat, a recently developed xanthine oxidase inhibitor, is expected to have fewer adverse effects than allopurinol because it has different mechanism of action from alloprinol. However, its dosage, usage and safety have not been established in patients with impaired renal function or those undergoing dialysis at the development since no studies was conducted in these patients. METHODS: Cross over clinical trial using 3 months of allopurinol and topiroxostat on 27 maintain Japanese HD patients were carried out...
July 2018: Hemodialysis International
Hsu-Wen Chou, Hsien-Tsai Chiu, Ching-Wei Tsai, I-Wen Ting, Hung-Chieh Yeh, Han-Chun Huang, Chin-Chi Kuo
Background: Direct comparisons of the effectiveness of allopurinol with that of other urate-lowering agents in chronic kidney disease (CKD) populations, as well as guideline recommendations for clinical practice, are lacking. Methods: We constructed a pharmacoepidemiology cohort study by including patients from Taiwan's long-term integrated CKD care program to compare the effectiveness among allopurinol, febuxostat and benzbromarone in reducing the risk of progression to dialysis...
November 17, 2017: Nephrology, Dialysis, Transplantation
Ana Beatriz Vargas-Santos, Tuhina Neogi
Hyperuricemia and gout, the clinical manifestation of monosodium urate crystal deposition, are common in patients with chronic kidney disease (CKD). Although the presence of CKD poses additional challenges in gout management, effective urate lowering is possible for most patients with CKD. Initial doses of urate-lowering therapy are lower than in the non-CKD population, whereas incremental dose escalation is guided by regular monitoring of serum urate levels to reach the target level of <6mg/dL (or <5mg/dL for patients with tophi)...
September 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Toshio Obata, Michiko Nakashima
Examined in the present study, allopurinol are xanthine oxidase inhibitors for use in rat hearts in vivo dialysis technology and ventricular myocardial intersitial adenosine production can increase. The microdialysis probe was implanted in the left ventricular myocardium of anesthetized rat hearts and the tissue in the vicinity of the dialysis was perfused with Tyrode's solution containing adenosine 5'-monophosphate (AMP) through the dialysis probe at a rate of 1.0ml/min to assess the activity of ecto-5'-nucleotidase...
June 15, 2017: European Journal of Pharmacology
Vivian S Tan, Amit X Garg, Eric McArthur, Ngan N Lam, Manish M Sood, Kyla L Naylor
BACKGROUND AND OBJECTIVES: The risk of gout across CKD stages is not well described. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a retrospective cohort study using linked health care databases from Ontario, Canada from 2002 to 2010. The primary outcome was the 3-year cumulative incidence of gout, on the basis of diagnostic codes. We presented our results by level of kidney function (eGFR≥90 ml/min per 1.73 m2 , 60-89, 45-59, 30-44, 15-29, and chronic dialysis) and by sex...
April 3, 2017: Clinical Journal of the American Society of Nephrology: CJASN
Daniel Fb Wright, Matthew P Doogue, Murray L Barclay, Peter T Chapman, Nicholas B Cross, John H Irvine, Lisa K Stamp
PURPOSE: The aims of this study were to characterise the population pharmacokinetics of oxypurinol in patients receiving haemodialysis and to compare oxypurinol exposure in dialysis and non-dialysis patients. METHODS: Oxypurinol plasma concentrations from 6 gout people receiving haemodialysis and 19 people with gout not receiving dialysis were used to develop a population pharmacokinetic model in NONMEM. Deterministic simulations were used to predict the steady-state area under the oxypurinol plasma concentration time curve over 1 week (AUC7days)...
January 2017: European Journal of Clinical Pharmacology
Francisco Caravaca, Boris Gonzales, Miguel Ángel Bayo, Enrique Luna
INTRODUCTION: Chronic musculoskeletal pain (CMP) is a very common symptom in patients with chronic kidney disease (CKD), and is associated with a significant deterioration in quality of life. AIMS: To determine the prevalence and clinical characteristics associated with CMP in patients with advanced CKD not on dialysis, and to analyse their relation with other uraemic symptoms and their prognosis significance. MATERIAL AND METHODS: Cross-sectional study to analyse the uraemic symptoms of an unselected cohort of patients with CKD stage 4-5 pre-dialysis...
July 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Dilraj Kaur Kahlon, Veronique Dinand, Satya Prakash Yadav, Anupam Sachdeva
We report here a study on efficacy of sevelamer hydrochloride in treating hyperphosphatemia due to tumor lysis syndrome (TLS) in a developing world setting. Twenty one children with hyperphosphatemia due to TLS were included. All received hyper-hydration, allopurinol and sevelamer. Efficacy was assessed by decrease in serum phosphate level, calcium-phosphate product and TLS score as per Cairo Bishop definition. Four children who underwent dialysis were excluded from analysis. Among the remaining 17 patients with hyperphosphatemia, laboratory TLS was recorded in 15 patients and clinical TLS in five...
March 2016: Indian Journal of Hematology & Blood Transfusion
Lisa K Stamp, Peter T Chapman, Suetonia C Palmer
Allopurinol is the most commonly used urate lowering therapy in the management of gout. Despite the fact that it has been available for over 40 years there is ongoing debate about optimal allopurinol dosing in gout patients with chronic kidney disease. Given that gout is common in patients with renal impairment, clinicians need to be aware of the relationships between serum urate and kidney function as well as the effects of allopurinol on kidney function and vice versa. The use of allopurinol in patients on dialysis is an understudied area...
January 2016: Joint, Bone, Spine: Revue du Rhumatisme
Henok Getachew, Yewondwossen Tadesse, Workineh Shibeshi
BACKGROUND: Dose adjustment for certain drugs is required in patients with reduced renal function to avoid toxicity as many drugs are eliminated by the kidneys. The aim of this study was to assess whether appropriate dosage adjustments were made in hospitalized patients with renal impairment. METHODS: A prospective cross-sectional study was carried out in the internal medicine wards of Tikur Anbessa Specialized Hospital. All patients with creatinine clearance ≤ 59 ml/min admitted to hospital between April and July, 2013 were included in the analysis...
2015: BMC Nephrology
Guillaume Bollée, Pierre Cochat, Michel Daudon
PURPOSE OF REVIEW: To provide transplant physicians with a summary of the pathogenesis and diagnosis of adenine phosphoribosyl transferase (APRT) deficiency and primary hyperoxaluria and, focussed on kidney transplantation, and to discuss interventions aimed at preventing and treating the recurrence of crystalline nephropathy in renal transplant recipients. SOURCE OF INFORMATION: Pubmed literature search. SETTING: Primary hyperoxaluria and APRT deficiency are rare inborn errors of human metabolism...
2015: Canadian Journal of Kidney Health and Disease
David J Perkowski, Susan Wagner, Kathryn Muller, Joseph R Schneider, J A St Cyr
PURPOSE: Assessment of both short- and long-term outcomes in patients undergoing off-pump coronary artery bypass using a perioperative metabolic protocol. METHODS: A total of 975 of 995 adult patients underwent coronary artery bypass 'off-pump' from 1997 through 2006. Patients presenting in cardiogenic shock were excluded from this assessment. A perioperative metabolic protocol, which included the implementation of allopurinol, insulin supplementation, magnesium sulfate, supplemental corticosteroids, milrinone, norepinephrine (prn), aspirin, clopidogrel, statins and β-blockers, was used in these patients...
December 2015: Therapeutic Advances in Cardiovascular Disease
Marian Goicoechea, Soledad Garcia de Vinuesa, Ursula Verdalles, Eduardo Verde, Nicolas Macias, Alba Santos, Ana Pérez de Jose, Santiago Cedeño, Tania Linares, Jose Luño
BACKGROUND: Asymptomatic hyperuricemia increases renal and cardiovascular (CV) risk. We previously conducted a 2-year, single-blind, randomized, controlled trial of allopurinol treatment that showed improved estimated glomerular filtration rate and reduced CV risk. STUDY DESIGN: Post hoc analysis of a long-term follow-up after completion of the 2-year trial. SETTING & PARTICIPANTS: 113 participants (57 in the allopurinol group and 56 in the control group) initially followed up for 2 years and 107 participants followed up to 5 additional years...
April 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Hakan Nacak, Merel van Diepen, Moniek C M de Goeij, Joris I Rotmans, Friedo W Dekker
BACKGROUND: In patients with chronic kidney disease (CKD) hyperuricemia is common. Evidence that hyperuricemia might also play a causal role in vascular disease, hypertension and progression of CKD is accumulating. Therefore, we studied the association between baseline uric acid (UA) levels and the rate of decline in renal function and time until start of dialysis in pre-dialysis patients. METHODS: Data from the PREPARE-2 study were used. The PREPARE-2 study is an observational prospective cohort study including incident pre-dialysis patients with CKD stages IV-V in the years between 2004 and 2011...
2014: BMC Nephrology
Yuki Tsuruta, Kosaku Nitta, Tadao Akizawa, Shunichi Fukuhara, Akira Saito, Angelo Karaboyas, Yun Li, Friedrich K Port, Bruce M Robinson, Ronald L Pisoni, Takashi Akiba
PURPOSE: Allopurinol, for treating hyperuricemia, is associated with lower mortality among hyperuricemic patients without chronic kidney disease (CKD). Greater allopurinol utilization in hemodialysis (HD) in Japan versus other countries provides an opportunity for understanding allopurinol-related HD outcomes. METHODS: Data from 6,252 Japanese HD patients from phases 1-3 of the Dialysis Outcomes and Practice Patterns Study (1999-2008) at ~60 facilities per phase were analyzed...
September 2014: International Urology and Nephrology
Siren Sezer, Sebnem Karakan, Berna Atesagaoglu, F Nurhan Ozdemir Acar
To determine the effect of hyperuricemia and allopurinol therapy on renal functions in chronic kidney disease (CKD) stage 3-4, we studied 96 patients in stage 3-4 CKD (57% male, age 65.3 ± 12.4 years). The mean estimated glomerular filtration rate (GFR) was 44.62 ± 14.38 iriL/ min/1.73 m 2 . The study patients were divided into non-allopurinol users (n = 47) and those using allopurinol (n = 49) in the last 12 months. Serum uric acid (UA) and C-reactive protein levels decreased after allopurinol therapy (P = 0...
March 2014: Saudi Journal of Kidney Diseases and Transplantation
F Perry Wilson, Jeffrey S Berns
Tumor lysis syndrome (TLS) is an oncologic emergency triggered by the rapid release of intracellular material from lysing malignant cells. Most common in rapidly growing hematologic malignancies, TLS has been reported in virtually every cancer type. Central to its pathogenesis is the rapid accumulation of uric acid derived from the breakdown of nucleic acids, which leads to kidney failure by various mechanisms. Kidney failure then limits the clearance of potassium, phosphorus, and uric acid leading to hyperkalemia, hyperphosphatemia, and secondary hypocalcemia, which can be fatal...
January 2014: Advances in Chronic Kidney Disease
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