Increasing of glomeral filtration rate in the setting of serum uric acid normalization in high cardiovascular risk patients – clinical observations
- Authors: Gaydukova I.Z.1,2, Mazurov V.I.1,2, Inamova O.V.1,2, Tsinzerling A.Y.1,2, Bashkinov R.A.1,2
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Affiliations:
- I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia
- Clinical Rheumatological Hospital No. 25
- Issue: Vol 9, No 3 (2023)
- Pages: 141-147
- Section: ACTUAL ISSUES OF PHARMACOTHERAPY AND PREVENTIVE TREATMENT
- URL: https://journals.eco-vector.com/2412-4036/article/view/516480
- DOI: https://doi.org/10.18565/therapy.2023.3.141–147
- ID: 516480
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Abstract
An increase in serum uric acid is an independent cardiovascular risk factor.
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.
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About the authors
Inna Z. Gaydukova
I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatological Hospital No. 25
Author for correspondence.
Email: ubp1976@list.ru
ORCID iD: 0000-0003-3500-7256
SPIN-code: 3083-7996
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
Russian Federation, Saint Petersburg; Saint PetersburgVadim I. Mazurov
I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatological Hospital No. 25
Email: maz.nwgmu@yandex.ru
ORCID iD: 0000-0002-0797-2051
SPIN-code: 6823-5482
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
Russian Federation, Saint Petersburg; Saint PetersburgOksana V. Inamova
I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatological Hospital No. 25
Email: b25@zdrav.spb.ru
ORCID iD: 0000-0001-9126-3639
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
Russian Federation, Saint Petersburg; Saint PetersburgAlexandra Yu. Tsinzerling
I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatological Hospital No. 25
Email: aleksa.fonturenko@mail.ru
ORCID iD: 0000-0003-4860-0518
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
Russian Federation, Saint Petersburg; Saint PetersburgRoman A. Bashkinov
I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia; Clinical Rheumatological Hospital No. 25
Email: bashkinov-roman@mail.ru
ORCID iD: 0000-0001-9344-1304
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
Russian Federation, Saint Petersburg; Saint PetersburgReferences
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