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The Association between High-Dose Allopurinol and Erythropoietin Hyporesponsiveness in Advanced Chronic Kidney Disease: JOINT-KD Study.
Oikawa, Megumi; Nishiwaki, Hiroki; Hasegawa, Takeshi; Sasaki, Sho; Yazawa, Masahiko; Miyazato, Hitoshi; Saka, Yosuke; Shimizu, Hideaki; Fujita, Yoshiro; Murakami, Minoru; Uchida, Daisuke; Kawarazaki, Hiroo; Omiya, Shinya; Sasai, Fumihiko; Koiwa, Fumihiko.
Afiliación
  • Oikawa M; Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.
  • Nishiwaki H; Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.
  • Hasegawa T; Showa University Research Administration Center (SURAC), Showa University, Tokyo, Japan.
  • Sasaki S; Division of Nephrology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.
  • Yazawa M; Showa University Research Administration Center (SURAC), Showa University, Tokyo, Japan.
  • Miyazato H; Department of Nephrology, Aso Iizuka Hospital, Iizuka, Japan.
  • Saka Y; Clinical Research Support Office, Aso Iizuka Hospital, Iizuka, Japan.
  • Shimizu H; Department of Healthcare Epidemiology, Kyoto University Graduate School of Public Health, Kyoto, Japan.
  • Fujita Y; Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
  • Murakami M; Department of Medicine, Okinawa Prefectural Yaeyama Hospital, Okinawa, Japan.
  • Uchida D; Department of Nephrology, Kasugai Municipal Hospital, Kasugai, Japan.
  • Kawarazaki H; Department of Nephrology, Daido Hospital, Nagoya, Japan.
  • Omiya S; Department of Nephrology, Chubu Rosai Hospital, Nagoya, Japan.
  • Sasai F; Department of Rheumatology, Chubu Rosai Hospital, Nagoya, Japan.
  • Koiwa F; Department of Nephrology, Saku Central Hospital, Saku, Japan.
Nephron ; 148(7): 448-456, 2024.
Article en En | MEDLINE | ID: mdl-38342092
ABSTRACT

INTRODUCTION:

The aim of the study was to explore the association between urate-lowering agents and reduced response to erythropoietin-stimulating agents in patients suffering from chronic kidney disease G5.

METHODS:

We conducted a cross-sectional, multicenter study in Japan between April and June 2013, enrolling patients aged 20 years or older with an estimated glomerular filtration rate of ≤15 mL/min/1.73 m2. Exclusion criteria encompassed patients with a history of hemodialysis, peritoneal dialysis, or organ transplantation. The patients were categorized into four groups based on the use of urate-lowering drugs high-dose allopurinol (>50 mg/day), low-dose allopurinol (≤50 mg/day), febuxostat, and no-treatment groups. We used a multivariable logistic regression model, adjusted for covariates, to determine the odds ratio (OR) for erythropoietin hyporesponsiveness, defined by an erythropoietin resistance index (ERI) of ≥10, associated with urate-lowering drugs.

RESULTS:

A total of 542 patients were included in the analysis, with 105, 36, 165, and 236 patients in the high-dose allopurinol, low-dose allopurinol, febuxostat, and no-treatment groups, respectively. The median and quartiles of ERIs were 6.3 (0, 12.2), 3.8 (0, 11.2), 3.4 (0, 9.8), and 4.8 (0, 11.2) in the high-dose allopurinol, low-dose allopurinol, febuxostat, and no-treatment groups, respectively. The multivariate regression model showed a statistically significant association between the high-dose allopurinol group and erythropoietin hyporesponsiveness, compared to the no-treatment group (OR = 1.98, 95% confidence interval 1.10-3.57).

CONCLUSIONS:

Our study suggests that the use of high-dose allopurinol exceeding the optimal dose may lead to hyporesponsiveness to erythropoiesis-stimulating agents.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alopurinol / Eritropoyetina / Insuficiencia Renal Crónica Tipo de estudio: Clinical_trials / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Nephron Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alopurinol / Eritropoyetina / Insuficiencia Renal Crónica Tipo de estudio: Clinical_trials / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Nephron Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Suiza