Search

Background. Clinical studies of urate-lowering therapy (ULT) use in multimorbid patients, including those with chronic kidney disease (CKD), are important in modern medical science. The purpose was to determine the efficacy and safety of ULT in patients with hyperuricemia and comorbid conditions, including people with chronic kidney disease, in real clinical practice. Materials and methods. This prospective comparative clinical study “Liquestia: comparative efficacy and safety in gouty arthritis patients with comorbid diseases and in patients with hyperuricemia and chronic kidney disease” was conducted in real clinical practice with the involvement of 124 patients with hyperuricemia, who were prescribed either febuxostat (Liquestia, JSC “Farmak”/Adenuric, Berlin Chemie) or allopurinol as ULT. Results. Individuals who received febuxostat significantly more often and faster reached the target levels of uric acid compared to patients who underwent treatment by allopurinol, regardless of glomerular filtration rate (GFR), except those from dialysis subgroup, and the presence of comorbidities. Patients in febuxostat subgroups during the study showed an increase in GFR after 6 months of treatment — at the level of the trend in the group with baseline GFR ≥ 60 ml/min and at a statistically significant level — in CKD stage 3–4, which could be the evidence of renoprotective effect of febuxostat with reduced GFR, while people receiving allopurinol tended to further decrease of GFR in 31.8 % of cases. Conclusions. The use of Liquestia for the treatment of patients with hyperuricemia and various comorbid conditions is no less effective than the use of Adenuric and more effective than allopurinol and helps achieve the target levels of uric acid in 90 % of cases within 6 months of treatment, which accompanied by a statistically significant increase in GFR in patients with CKD stage 3–4.

The authors conducted a study on 35 white Wistar outbred rats to investigate the possibility of correcting acute kidney damage induced by the administration of phenylhydrazine at a dose of 100 mg/kg by introducing a mixture of sodium chloride and sodium bicarbonate solutions into the body. The research results identified changes in the kidneys upon phenylhydrazine administration, including the loss of some capillary glomeruli, eosinophilic deposits in Bowman's spaces and tubular lumens, and lymphoid infiltration in the interstitium. Rats receiving a mixture of sodium chloride and sodium bicarbonate solutions in their drinking water showed positive changes in their kidneys: no loss of capillary glomeruli was observed, and eosinophilic deposits were absent in most tubules. Lymphocyte aggregation was only observed around some renal vessels. The authors suggest that the intake of additional sodium and bicarbonate into the body, along with alkalinization of the primary urine, promotes the excretion of hemolysis products caused by phenylhydrazine, which contributes to renoprotection and preservation of renal parenchyma.

Background. Clinical studies of urate-lowering therapy (ULT) use in multimorbid patients, including those with chronic kidney disease (CKD), are important in modern medical science. The purpose was to determine the efficacy and safety of ULT in patients with hyperuricemia and comorbid conditions, including people with chronic kidney disease, in real clinical practice. Materials and methods. This prospective comparative clinical study “Liquestia: comparative efficacy and safety in gouty arthritis patients with comorbid diseases and in patients with hyperuricemia and chronic kidney disease” was conducted in real clinical practice with the involvement of 124 patients with hyperuricemia, who were prescribed either febuxostat (Liquestia, JSC “Farmak”/ Adenuric, Berlin Chemie) or allopurinol as ULT. Results. Individuals who received febuxostat significantly more often and faster reached the target levels of uric acid compared to patients who underwent treatment by allopurinol, regardless of glomerular filtration rate (GFR), except those from dialysis subgroup, and the presence of comorbidities. Patients in febuxostat subgroups during the study showed an increase in GFR after 6 months of treatment — at the level of the trend in the group with baseline GFR ≥ 60 ml/min and at a statistically significant level — in CKD stage 3–4, which could be the evidence of renoprotective effect of febuxostat with reduced GFR, while people receiving allopurinol tended to further decrease of GFR in 31.8 % of cases. Conclusions. The use of Liquestia for the treatment of patients with hyperuricemia and various comorbid conditions is no less effective than the use of Adenuric and more effective than allopurinol and helps achieve the target levels of uric acid in 90 % of cases within 6 months of treatment, which accompanied by a statistically significant increase in GFR in patients with CKD stage 3–4. [ABSTRACT FROM AUTHOR]

Copyright of Pocki is the property of Zaslavsky O.Yu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Renoprotection is a system of measures for primarily pharmacological control, contributing to the continued preservation of renal function. When choosing renoprotection tactics, it is necessary to consider not only the estimated GFR (using the EPI formula), but also a functional renal reserve. The method of determining the renal reserve with oral administration of 0.45–0.50% sodium chloride solution at the rate of 0.5 % of body weight is considered to be physiologically substantiated. The renal reserve determining based on this technique as a routine method for examining nephrological patients provides additional information not only on the number of functioning nephrons, but also on their condition. A differentiated approach to prescribing renoprotective agents has been proposed, taking into account the stage of the disease and the functional renal reserve for maximum preservation of functioning nephrons.

The article presents a clinical case of chronic kidney disease and chronic renal failure in a child with perinatal hypoxia and acute renal failure on the background of renal vein thrombosis in the early neonatal period, who received renoprotective agents within 7 years of life that helped us to stabilize renal function.

Acute kidney injury (AKI) is a clinical syndrome which incidence increases dramatically over the past years in both developing and developed countries. It is considered as an independent risk factor for mortality in critically ill patients as well as complicates the course of a significant number of diseases. Consequently, there is a great need for new effective renoprotective options. Our research was conducted to evaluate the renoprotective potential of organospecific peptides (peptide kidney complex, synthetic oligopeptides AED, EDL and AEDG) in comparison with antioxidant drug mexidol (emoxypine succinate) and pineal hormone melatonin. An integral criterion of renoprotective activity was a survival rate of animals under the conditions of AKI of different genesis: induced by ethylene glycol, cisplatin, gentamicin, rhabdomyolysis and ischemia-reperfusion. All of the studied peptides decreased mortality of animals, while the most significant protective effect was shown by peptide EDL, confirmed by 33.3% survival rate on the 5th day of ethylene glycol intoxication development and 100% survival on the other models of AKI. The least effective was peptide AED, as it prevented mortality only in animals with cisplatin-induced AKI. Obtained results show the renoprotective potential of organospecific peptides and give the background for their further study.

In experiments on rats it was found that the administration of phenylhydrazine in doses of 10 mg, 50 mg and 100 mg / kg of body weight accompanied by a dose-dependent morphological damage of the kidneys. By comparing the morphological disorders in kidneys of rats were used for drinking tap water, 1% NaCl solution or a 0.75% NaCl and 0,36% NaHCO3 found that brines possess nephroprotective activity. The greatest protective effect with respect to kidney toxicity with phenylhydrazine possessed solution containing chloride and sodium bicarbonate.