EFFECT OF TREATMENT WITH ALLOPURINOL ON MARKERS OF MICROINFLAMMATION AND VASCULAR DAMAGE AND REPAIR IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND ASYMPTOMATIC HYPERURICEMIA. (June 2018)

• Record Type: Journal Article
• Authors: Santamaria, R.; Buendia, P.; Mier, V. Pendon-Ruiz De; Martinez-Moreno, J.; Vergara, N.; Jimenez-Moral, M.; Muñoz-Castañeda, J.; Rodriguez, J.; Aljama, P.
• Is Part Of: Journal of hypertension. Volume 36(2018)Supplement 1
• Publication Date: 2018-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000539316.33948.8a
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract: Objective: Asymptomatic hyperuricemia (AH) is common in patients with chronic kidney disease (CKD). However, in patients with CKD the effects of AH treatment on the mechanisms of vascular damage and repair are unknown. Objective: To study the effect of inhibition of xanthine oxidase with allopurinol on the mechanisms of vascular injury and repair in patients with CKD and AH, evaluating the effect on markers of vascular damage and repair, oxidative stress and microinflammation. Design and method: Randomized clinical trial, double-blind, placebo-controlled, crossover design with 4-week treatment period with either allopurinol 100 mg orally daily or placebo, 4-week wash-out period and 4-week period of treatment with placebo or allopurinol. Studies performed at first and last visit of each treatment period: 1) vascular damage and repair mechanisms markers: microparticles derived from endothelial cells (MPs), circulating endothelial progenitor cells (EPCs), vascular growth factors, 2) oxidative stress: xanthine oxidase and superoxide dismutase and 3) microinflammation: monocytes subpopulations and cytokines. Results: 23 patients finished the study (65.2% men, age 57.52 ± 11.75 years, baseline MDRD-4 42.1 ± 11.2 ml/min/1.73 m2, urinary albumin/creatinine ratio 0.29 ± 0.39 mg/mg and serum uric acid levels of 8.3 ± 1 mg/dl). There were no differences in baseline uric acid levels at the start of each study period. Treatment with allopurinol significantly reduced serum uric acid levels to 7 ± 1.1 mg/dl (p < 0.05). Treatment with placebo did not reduce uric acid levels (baseline 8.7 ± 1.5 mg/dl, final 8.5 ± 1.3 mg/dl, NS). Allopurinol induced a reduction in xanthine oxidase of 2 ± 24.1% versus a placebo increase of 12.8 ± 29.6% (p = 0.03). No effect was observed on superoxide dismutase, MPs and, percentage of CD14 / CD16 monocytes subpopulations, vascular growth factors, interleukins and chemotactic factors. Conclusions: In patients with CKD and AH, 100 mg of allopurinol daily for 4 weeks compared to placebo did not induce significant changes in mechanisms of vascular damage and repair, oxidative stress and microinflammation.