Abstract:

Objective To investigate the safety and efficacy of febuxostat in the treatment of patientswith hyperuricemia after renal transplantation. Methods The clinical data of renal transplant recipients whowere regularly followed up in Shanghai Changzheng Hospital from January 2016 to December 2017，were analyzed retrospectively. They were received traditional uric acid reduction therapy〔lifestyle intervention，alkalized urine，allopurinol（0.1 ～ 0.2 g/d）or phenyl bromide Malone（50 mg/d）〕for at least 4 weeks，a total of 104 patients with hyperuricemia were diagnosed with hyperuricemia，these patients were switched to oral febuxostat on the basis ofdiscontinuation of allopurinol or benzbromarone with follow-up of 12 weeks，the changes of blood uric acid level and adverse reactions before and after treatment with febuxostat were compared，and the concentrations of immunosuppressive drugs were observed. Results The serum uric acid level before treatment with febuxostatwas（497.88±47.37）μmol/L，andthe blood uric acid level decreased significantly to（348.05±49.88）μmol/L at the12th week after treatment（P ＜ 0.001）. There were no significant differences in white blood cell，serum creatinine，and immunosuppressive drug concentration levels. No cardiovascular events occurred during the observation，and2 patients with acute gout after the medication were cured.Conclusion When the traditional comprehensive treatment of hyperuricemia after renal transplantation is not effective，the conversion to febuxostat is effective and safe.

Key words: Renal transplantation； Hyperuricemia, Febuxostat

摘要：

目的 探讨肾移植术后合并高尿酸血症（hyperuricemia，HUA）患者应用非布索坦的安全性和有效性。方法 回顾性分析 2016 年 1 月—2017 年 12 月在本院规律随访的肾移植受者的临床资料，接受传统降尿酸治疗〔生活方式干预、碱化尿液、别嘌醇（0.1 ～ 0.2 g/d）或苯溴马隆（50 mg/d）〕至少 4 周，血尿酸（serum uric acid，SUA）水平仍可诊断为 HUA 的共 104 例患者，在停用别嘌醇或苯溴马隆基础上转为口服非布索坦，随访 12 周，比较非布索坦治疗前后 SUA 水平变化及不良反应。同时观察免疫抑制剂药物浓度等指标。结果 非布索坦治疗前 SUA 水平为（497.88±47.37）μmol/L，治疗后第十二周 SUA 水平明显下降至（348.05±49.88）μmol/L（P ＜ 0.001）。观察治疗前后丙氨酸转氨酶、血白细胞计数、血肌酐及免疫抑制剂药物浓度，均无显著性差异。观察过程中无心血管事件发生，用药后有 2 例出现痛风急性发作，对症处理后均好转。结论肾移植术后 HUA 应用传统综合治疗效果不佳时，转换为非布索坦治疗效果确切，且安全性高。

关键词: 肾移植 , 高尿酸血症 , 非布索坦