Author:
Kataoka Hiroshi,Mochizuki Toshio,Ohara Mamiko,Tsuruta Yuki,Iwasa Naomi,Yoshida Rie,Tsuchiya Ken,Nitta Kosaku,Kimura Kenjiro,Hosoya Tatsuo,Kimura Kenjiro,Hosoya Tatsuo,Ito Sadayoshi,Inaba Masaaki,Tomino Yasuhiko,Uchida Shunya,Makino Hirofumi,Matsuo Seiichi,Yamanaka Hisashi,Yamamoto Tetsuya,Ohno Iwao,Shibagaki Yugo,Iimuro Satoshi,Imai Naohiko,Kuwabara Masanari,Hayakawa Hiroshi,Akizawa Tadao,Teramoto Tamio,Kasanuki Hiroshi,Yoshimura Kenichi,Kimura Kenjiro,Hosoya Tatsuo,Shibagaki Yugo,Ohno Iwao,Sato Hiroshi,Uchida Shunya,Horikoshi Satoshi,Maruyama Syoichi,Inaba Masahiko,Moriwaki Yuji,Uchida Haruhito,Kaneshiro Nagayuki,Imai Naohiko,Moriya Hidekazu,Komatsu Yasuhiro,Kaname Shinya,Hanaoka Kazunari,Ogura Makoto,Ikeda Masato,Kasai Kenji,Sugiura Akira,Takahashi Kazushi,Kojima Kenichiro,Nitta Kosaku,Tamai Hirofumi,Nagaya Hiroshi,Okuno Senji,Kakiya Ryusuke,Takeoka Hiroya,Hirata Kyouji,Asano Kenichiro,Fukaya Yasuo,Iwaida Yasushi,Tsuneda Yasuo,Nishimura Shigeaki,Hiramatsu Takeyuki,Isaka Yoshitaka,Ito Takafumi,Yuzawa Yukio,Yamagata Kunihiro,Sofue Tadashi,Jinguji Yoshimi,Hirano Keita,Matsuyama Kazuhiro,Mizumoto Teruhiko,Shibuya Yuko,Sugawara Masahiro,Kadomura Moritoshi,Teshima Yasuaki,Ohtani Hiroshi,Kamata Hiroki,Okawara Susumu,Fukushima Masaki,Takemura Katsumi,Kinugasa Eriko,Kogure Masami,Ehara Yoichi, , , , , ,
Abstract
AbstractAttribute-based medicine is essential for patient-centered medicine. To date, the groups of patients with chronic kidney disease (CKD) requiring urate-lowering therapy are clinically unknown. Herein, we evaluated the efficacy of febuxostat using a cross-classification, attribute-based research approach. We performed post hoc analysis of multicenter, randomized, double-blind, placebo-controlled trial data for 395 patients with stage 3 CKD and asymptomatic hyperuricemia. Participants were divided into febuxostat or placebo groups and subcohorts stratified and cross-classified by proteinuria and serum creatinine concentrations. In patients stratified based on proteinuria, the mean eGFR slopes were significantly higher in the febuxostat group than in the placebo group (P = 0.007) in the subcohort without proteinuria. The interaction between febuxostat treatment and presence of proteinuria in terms of eGFR slope was significant (P for interaction = 0.019). When cross-classified by the presence of proteinuria and serum creatinine level, the mean eGFR slopes significantly differed between the febuxostat and placebo groups (P = 0.040) in cross-classified subcohorts without proteinuria and with serum creatinine level ≥ median, but not in the cross-classified subcohorts with proteinuria and serum creatinine level < median. Febuxostat mitigated the decline in kidney function among stage 3 CKD patients with asymptomatic hyperuricemia without proteinuria.
Publisher
Springer Science and Business Media LLC