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Original ArticlesClinical Nephrology
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A Randomized Study of Allopurinol on Endothelial Function and Estimated Glomular Filtration Rate in Asymptomatic Hyperuricemic Subjects with Normal Renal Function

Mehmet Kanbay, Bulent Huddam, Alper Azak, Yalcin Solak, Gulay Kocak Kadioglu, Ismail Kirbas, Murat Duranay, Adrian Covic and Richard J. Johnson
CJASN August 2011, 6 (8) 1887-1894; DOI: https://doi.org/10.2215/CJN.11451210
Mehmet Kanbay
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Bulent Huddam
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Alper Azak
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Yalcin Solak
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Gulay Kocak Kadioglu
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Ismail Kirbas
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Murat Duranay
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Adrian Covic
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Richard J. Johnson
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This article has a correction. Please see:

  • A Randomised Study of Allopurinol on Endothelial Function and eGFR in Asymptomatic Hyperuricemic Subjects with Normal Renal Function. - December 01, 2011

Abstract

Background and objectives Endothelial dysfunction is an early manifestation of vascular injury and contributes to the development of atherosclerotic cardiovascular disease. Recent studies have implicated hyperuricemia as a risk factor for cardiovascular disease. We hypothesized that lowering uric acid in subjects with asymptomatic hyperuricemia with allopurinol might improve endothelial dysfunction, BP, estimated GFR (eGFR), and inflammatory markers.

Design, setting, participants, & measurements Subjects with asymptomatic hyperuricemia and no history of gout and 30 normouricemic control subjects were enrolled in this 4-month randomized prospective study. Thirty hyperuricemic patients received 300 mg/d allopurinol and were compared with 37 hyperuricemic patients and 30 normouricemic subjects in matched control groups. Flow-mediated dilation (FMD), eGFR, ambulatory BP monitoring, spot urine protein-creatine ratio, and highly sensitive C-reactive protein were measured at baseline and at 4 months.

Results Age, gender, lipid profile, eGFR, hemoglobin, glucose, and level of proteinuria were similar in hyperuricemic subjects and controls at baseline. As expected, hyperuricemic patients had higher levels of highly sensitive C-reactive protein and lower FMD compared with normouricemic patients. Allopurinol treatment resulted in a decrease in serum uric acid, a decrease in systolic BP, an increase in FMD, and an increase in eGFR compared with baseline. No significant difference was observed in the control hyperuricemic and normouricemic groups. In a multiple regression analysis, FMD levels were independently related to uric acid both before (beta = −0.55) and after (beta = −0.40) treatment.

Conclusions Treatment of hyperuricemia with allopurinol improves endothelial dysfunction and eGFR in subjects with asymptomatic hyperuricemia.

  • Received December 27, 2010.
  • Accepted April 1, 2011.
  • Copyright © 2011 by the American Society of Nephrology
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Clinical Journal of the American Society of Nephrology: 6 (8)
Clinical Journal of the American Society of Nephrology
Vol. 6, Issue 8
1 Aug 2011
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A Randomized Study of Allopurinol on Endothelial Function and Estimated Glomular Filtration Rate in Asymptomatic Hyperuricemic Subjects with Normal Renal Function
Mehmet Kanbay, Bulent Huddam, Alper Azak, Yalcin Solak, Gulay Kocak Kadioglu, Ismail Kirbas, Murat Duranay, Adrian Covic, Richard J. Johnson
CJASN Aug 2011, 6 (8) 1887-1894; DOI: 10.2215/CJN.11451210

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A Randomized Study of Allopurinol on Endothelial Function and Estimated Glomular Filtration Rate in Asymptomatic Hyperuricemic Subjects with Normal Renal Function
Mehmet Kanbay, Bulent Huddam, Alper Azak, Yalcin Solak, Gulay Kocak Kadioglu, Ismail Kirbas, Murat Duranay, Adrian Covic, Richard J. Johnson
CJASN Aug 2011, 6 (8) 1887-1894; DOI: 10.2215/CJN.11451210
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  • Urate Transporter URAT1 in Hyperuricemia: New Insights from Hyperuricemic Models
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  • Effect of Uric Acid-Lowering Agents on Endothelial Function: A Randomized, Double-Blind, Placebo-Controlled Trial
  • Are allopurinol dose and duration of use nephroprotective in the elderly? A Medicare claims study of allopurinol use and incident renal failure
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  • Serum Uric Acid Level, Longitudinal Blood Pressure, Renal Function, and Long-Term Mortality in Treated Hypertensive Patients
  • The role of uric acid in the pathogenesis of human cardiovascular disease
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