Русский
Increasing of glomeral filtration rate in the setting of serum uric acid normalization in high cardiovascular risk patients – clinical observations
DOI: https://dx.doi.org/10.18565/therapy.2023.3.141-147
Gaydukova I.Z., Mazurov V.I., Inamova O.V., Zinserling A.Yu., Bashkinov R.A.
1) I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, Saint Petersburg; 2) Clinical Rheumatological Hospital No. 25, Saint Petersburg
The aim: to describe cases of glomerular filtration rate (GFR) increasing in patients with chronic kidney disease (CKD) stage 3C with a high cardiovascular risk in the setting of persistent normalization of the level of uric acid in the blood serum due to febuxostat intake.
Material and methods. We observed patients born in 1958 and 1943 who had a decrease in GFR to 37 and 38,9 ml/min/1,73 m2 during 5 and 8 years, respectively.
Results. The genesis of kidney damage in patients was complex – in both cases there was arterial hypertension, diabetes mellitus, widespread atherosclerosis, obesity, dyslipidemia. The level of uric acid in the blood serum of both observed persons exceeded 500 µmol/l for at least 5 years. Nephritis, other autoimmune and inflammatory diseases as the cause of CKD were absent. The results of prescribing febuxostat (80/120 mg/day) against the background of a low-purine and low-calorie diet were the normalization of uric acid levels, a decrease in body weight, stabilization of blood pressure with a decrease in the need for antihypertensive therapy, which in combination led to a steady increase in GFR from 37 and 38,9 to 55 and 64.4 ml/min/1,73 m2, respectively.
Conclusion. Persistent normalization of serum uric acid levels may be associated with a decrease in the severity of CKD in patients with high cardiovascular risk, in case there is no primary kidney damage leading to hyperuricemia.
Literature
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About the Autors
Inna Z. Gaydukova, Dr. med. habil., deputy director of the Research Institute of Rheumatology, professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191014, Saint Petersburg, 41 Kirochnaya Str. E-mail: ubp1976@list.ru.
ORCID: https://orcid.org/0000-0003-3500-7256. SPIN-code: 3083-7996
Vadim I. Mazurov, Dr. med. habil., professor, academician of RAS, chief scientific consultant, director of the Research Institute of Rheumatology, head of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, head of the center for autoimmune diseases of Clinical Rheumatological Hospital No. 25, Honored Scientist of the Russian Federation. Address: 191014, Saint Petersburg, 41 Kirochnaya Str. E-mail: maz.nwgmu@yandex.ru. ORCID: https://orcid.org/0000-0002-0797-2051. SPIN-code: 6823-5482
Oksana V. Inamova, PhD in Medicine, chief physician of Clinical Rheumatological Hospital No. 25, deputy director of the Research Institute of Rheumatology, assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191014, Saint Petersburg, 41 Kirochnaya Str. E-mail: b25@zdrav.spb.ru. ORCID: https://orcid.org/0000-0001-9126-3639
Alexandra Yu. Tsinzerling, rheumatologist at Clinical Rheumatological Hospital No. 25, senior laboratory assistant/competitor at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191014, Saint Petersburg, 41 Kirochnaya Str. E-mail: aleksa.fonturenko@mail.ru.
ORCID: https://orcid.org/0000-0003-4860-0518
Roman A. Bashkinov, postgraduate student of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, rheumatologist at Clinical Rheumatological Hospital No. 25. Address: 191014, Saint Petersburg, 41 Kirochnaya Str. E-mail: bashkinov-roman@mail.ru.
ORCID: https://orcid.org/0000-0001-9344-1304
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