Efficacy of febuxostat on hyperuricemia and estimated glomerular filtration rate in patients with non-dialysis stage 3/4 chronic kidney disease and assessment of cardiac function: a 12-month interventional study

ObjectivesFebuxostat, an oral medication for treating hyperuricemia (HUA), is a non-purine xanthine oxidase inhibitor that regulates serum uric acid (SUA) metabolism in patients with chronic kidney disease (CKD). However, the drug’s effectiveness in improving renal function in patients with non-dial...

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Main Authors: Yousuf Abdulkarim Waheed, Fan Yang, Jie Liu, Shifaa Almayahe, Karthick Kumaran Munisamy Selvam, Disheng Wang, Dong Sun
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Nephrology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneph.2025.1526182/full
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author Yousuf Abdulkarim Waheed
Yousuf Abdulkarim Waheed
Fan Yang
Jie Liu
Shifaa Almayahe
Karthick Kumaran Munisamy Selvam
Disheng Wang
Disheng Wang
Disheng Wang
Dong Sun
Dong Sun
Dong Sun
author_facet Yousuf Abdulkarim Waheed
Yousuf Abdulkarim Waheed
Fan Yang
Jie Liu
Shifaa Almayahe
Karthick Kumaran Munisamy Selvam
Disheng Wang
Disheng Wang
Disheng Wang
Dong Sun
Dong Sun
Dong Sun
author_sort Yousuf Abdulkarim Waheed
collection DOAJ
description ObjectivesFebuxostat, an oral medication for treating hyperuricemia (HUA), is a non-purine xanthine oxidase inhibitor that regulates serum uric acid (SUA) metabolism in patients with chronic kidney disease (CKD). However, the drug’s effectiveness in improving renal function in patients with non-dialysis stage 3/4 CKD remains unclear. Our aim is to investigate the efficacy of febuxostat on kidney function. In addition, the cardiac function will be assessed.MethodWe conducted a single-center, interventional, randomized, controlled, open-label study. A total of 316 patients with non-dialysis stage 3/4 CKD, with SUA ≥6mg/dL in women and ≥7mg/dL in men, were assigned to either the febuxostat group (n=156) or the control group (n=160). The primary endpoint was the evaluation of changes in kidney biomarkers from baseline to 12 months of treatment, and any changes in cardiac biomarkers and echocardiographs were the secondary endpoint.ResultsThe primary endpoint was a comparison between the two groups from baseline to 12 months of treatment. SUA was significantly decreased in patients treated with febuxostat 40 mg (6.85 ± 0.41mg/dL at baseline and 5.27 ± 0.70mg/dL at 12 months of treatment, P<0.001) and this was associated with increased eGFR (34.48 ± 8.42ml/min at baseline and 38.46 ± 8.87ml/min at 12 months of treatment, P<0.001). There were significant decreases in high-sensitivity troponin T (19.50 ± 7.24ng/L at baseline and 16.98 ± 7.32ng/L at 12 months of treatment, P<0.001) and N-terminal-pro brain natriuretic peptide (941.35 ± 374.30pg/ml at baseline and 762.22 ± 303.32 pg/ml at 12 months of treatment, P<0.001) in the febuxostat group. These changes were also associated with increased left ventricular ejection fraction in the febuxostat group (50.47 ± 3.95% at baseline and 51.12 ± 3.96% at the end of the study, P<0.001).ConclusionIn the interventional group, febuxostat was well-tolerated and demonstrated a reduction in SUA associated with an increase in eGFR. This slowed down the progression of renal disease in patients with non-dialysis stage 3/4 CKD and improved cardiac function.
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spelling doaj-art-7998fbb148f146a4b7c83ee5e7c98e7f2025-08-20T02:40:48ZengFrontiers Media S.A.Frontiers in Nephrology2813-06262025-03-01510.3389/fneph.2025.15261821526182Efficacy of febuxostat on hyperuricemia and estimated glomerular filtration rate in patients with non-dialysis stage 3/4 chronic kidney disease and assessment of cardiac function: a 12-month interventional studyYousuf Abdulkarim Waheed0Yousuf Abdulkarim Waheed1Fan Yang2Jie Liu3Shifaa Almayahe4Karthick Kumaran Munisamy Selvam5Disheng Wang6Disheng Wang7Disheng Wang8Dong Sun9Dong Sun10Dong Sun11Department of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaClinical Research Center for Kidney Disease, Xuzhou Medical University, Xuzhou, ChinaDepartment of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Nephrology, the Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaMedical College, University of Fallujah, Al Anbar, IraqDepartment of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaClinical Research Center for Kidney Disease, Xuzhou Medical University, Xuzhou, ChinaDepartment of Internal Medicine and Diagnostics, Xuzhou Medical University, Xuzhou, ChinaDepartment of Nephrology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaClinical Research Center for Kidney Disease, Xuzhou Medical University, Xuzhou, ChinaDepartment of Internal Medicine and Diagnostics, Xuzhou Medical University, Xuzhou, ChinaObjectivesFebuxostat, an oral medication for treating hyperuricemia (HUA), is a non-purine xanthine oxidase inhibitor that regulates serum uric acid (SUA) metabolism in patients with chronic kidney disease (CKD). However, the drug’s effectiveness in improving renal function in patients with non-dialysis stage 3/4 CKD remains unclear. Our aim is to investigate the efficacy of febuxostat on kidney function. In addition, the cardiac function will be assessed.MethodWe conducted a single-center, interventional, randomized, controlled, open-label study. A total of 316 patients with non-dialysis stage 3/4 CKD, with SUA ≥6mg/dL in women and ≥7mg/dL in men, were assigned to either the febuxostat group (n=156) or the control group (n=160). The primary endpoint was the evaluation of changes in kidney biomarkers from baseline to 12 months of treatment, and any changes in cardiac biomarkers and echocardiographs were the secondary endpoint.ResultsThe primary endpoint was a comparison between the two groups from baseline to 12 months of treatment. SUA was significantly decreased in patients treated with febuxostat 40 mg (6.85 ± 0.41mg/dL at baseline and 5.27 ± 0.70mg/dL at 12 months of treatment, P<0.001) and this was associated with increased eGFR (34.48 ± 8.42ml/min at baseline and 38.46 ± 8.87ml/min at 12 months of treatment, P<0.001). There were significant decreases in high-sensitivity troponin T (19.50 ± 7.24ng/L at baseline and 16.98 ± 7.32ng/L at 12 months of treatment, P<0.001) and N-terminal-pro brain natriuretic peptide (941.35 ± 374.30pg/ml at baseline and 762.22 ± 303.32 pg/ml at 12 months of treatment, P<0.001) in the febuxostat group. These changes were also associated with increased left ventricular ejection fraction in the febuxostat group (50.47 ± 3.95% at baseline and 51.12 ± 3.96% at the end of the study, P<0.001).ConclusionIn the interventional group, febuxostat was well-tolerated and demonstrated a reduction in SUA associated with an increase in eGFR. This slowed down the progression of renal disease in patients with non-dialysis stage 3/4 CKD and improved cardiac function.https://www.frontiersin.org/articles/10.3389/fneph.2025.1526182/fullfebuxostathyperuricemiachronic kidney diseasecardiovasculartroponin
spellingShingle Yousuf Abdulkarim Waheed
Yousuf Abdulkarim Waheed
Fan Yang
Jie Liu
Shifaa Almayahe
Karthick Kumaran Munisamy Selvam
Disheng Wang
Disheng Wang
Disheng Wang
Dong Sun
Dong Sun
Dong Sun
Efficacy of febuxostat on hyperuricemia and estimated glomerular filtration rate in patients with non-dialysis stage 3/4 chronic kidney disease and assessment of cardiac function: a 12-month interventional study
Frontiers in Nephrology
febuxostat
hyperuricemia
chronic kidney disease
cardiovascular
troponin
title Efficacy of febuxostat on hyperuricemia and estimated glomerular filtration rate in patients with non-dialysis stage 3/4 chronic kidney disease and assessment of cardiac function: a 12-month interventional study
title_full Efficacy of febuxostat on hyperuricemia and estimated glomerular filtration rate in patients with non-dialysis stage 3/4 chronic kidney disease and assessment of cardiac function: a 12-month interventional study
title_fullStr Efficacy of febuxostat on hyperuricemia and estimated glomerular filtration rate in patients with non-dialysis stage 3/4 chronic kidney disease and assessment of cardiac function: a 12-month interventional study
title_full_unstemmed Efficacy of febuxostat on hyperuricemia and estimated glomerular filtration rate in patients with non-dialysis stage 3/4 chronic kidney disease and assessment of cardiac function: a 12-month interventional study
title_short Efficacy of febuxostat on hyperuricemia and estimated glomerular filtration rate in patients with non-dialysis stage 3/4 chronic kidney disease and assessment of cardiac function: a 12-month interventional study
title_sort efficacy of febuxostat on hyperuricemia and estimated glomerular filtration rate in patients with non dialysis stage 3 4 chronic kidney disease and assessment of cardiac function a 12 month interventional study
topic febuxostat
hyperuricemia
chronic kidney disease
cardiovascular
troponin
url https://www.frontiersin.org/articles/10.3389/fneph.2025.1526182/full
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