2024 Volume 48 Issue 2 Pages 105-114
Hyperuricemia is a strong risk factor for renal dysfunction, but the effect of uric acid-lowering agents on the renal function has not been uniformly demonstrated. The aim of this study was to evaluate the effect of the novel uricosuric agent dotinurad on serum uric acid (SUA) levels and the estimated glomerular filtration rate (eGFR) in patients with hyperuricemia. A cohort of 40 patients with reduced renal excretion of uric acid were enrolled, including 19 patients with chronic kidney disease (CKD). Patients started taking dotinurad at 0.5 mg/day and the dose was adjusted to achieve SUA levels of 6.0 mg/dL or lower.
Twenty-four weeks after starting the administration of dotinurad, its mean daily dose was 1.15±0.57 mg and the rates of achieving SUA at 6.0 mg/dL or lower were 50% in the 0.5-mg group, 78.9% in the 1-mg group, and 90.9% in the 2-mg group. The SUA level significantly decreased from 8.28±0.70 to 5.50±0.85 mg/dL (p<0.01) and eGFR significantly increased from 62.3 ±15.4 to 65.8±15.7 mL/min/1.73 m2 (p<0.01). A significant reduction in the SUA level (8.42±0.71 to 5.86±1.02 mg/dL, p<0.01) and significant increase in eGFR (47.4±10.4 to 53.2±13.3 mL/min/1.73 m2, p<0.01) were also observed in patients with CKD. The degree of increase in eGFR after starting the administration of dotinurad was correlated with the degree of decrease in serum UA (p<0.05) and eGFR at the baseline (p=0.02) in patients with CKD. Dotinurad administration to patients with hyperuricemia, including CKD patients, resulted in favorable SUA levels and improvement in the renal function.
