{"created":"2023-09-13T07:20:55.671217+00:00","id":2000027,"links":{},"metadata":{"_buckets":{"deposit":"81cd76aa-a6a1-4954-84f9-301a47527abb"},"_deposit":{"created_by":14,"id":"2000027","owner":"14","owners":[14],"pid":{"revision_id":0,"type":"depid","value":"2000027"},"status":"published"},"_oai":{"id":"oai:dmu.repo.nii.ac.jp:02000027","sets":["81:1693284379257"]},"author_link":[],"control_number":"2000027","item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2023-07-25","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"54","bibliographicPageStart":"46","bibliographicVolumeNumber":"50","bibliographic_titles":[{"bibliographic_title":"Dokkyo Journal of Medical Sciences"}]}]},"item_10001_description_34":{"attribute_name":"要旨","attribute_value_mlt":[{"subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_10001_description_35":{"attribute_name":"要旨(英)","attribute_value_mlt":[{"subitem_description_type":"Abstract"}]},"item_10001_description_6":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"慢性腎臓病（CKD）患者は血清尿酸値が高いことが多く，高尿酸血症は腎不全や脳心血管病の危険因子となる．腎機能が低下している場合，高尿酸血症治療薬として尿酸排泄促進薬は効果的ではなく，尿酸生成抑制薬であるアロプリノール（ALP）も副作用に注意を要するが，フェブキソスタット（FBX）などの非プリン系キサンチンオキシダーゼ阻害薬が腎不全患者にも用いられるようになり，選択的尿酸再吸収阻害薬であるドチヌラド（DTN）も導入されている．本研究では，CKDを合併する高尿酸血症に対するDTNおよびFBXの治療効果を比較した．\n　高尿酸血症を呈するCKD患者19例にDTN 0.5, 1, 2 mgあるいはFBX 10, 20, 40 mgを3-6か月ずつ投与する無作為交差試験を行った．各治療期終了時に血液・尿検査を行い，腎障害や心血管系危険因子を評価した．\n　血清尿酸値はDTN投与期とFBX投与期で同等であり（5.5 vs 5.1 mg/dL），推算糸球体濾過　（eGFR）＜45 mL/分/1.73 m2の症例においても有意差はなかった（5.5 vs 4.9 mg/dL）．血圧（121/79 vs 123/78 mmHg）や血清脂質，ヘモグロビンA1c（6.1 vs 6.2％）にDTNとFBXで有意差はなく，および血清クレアチニン（1.14 vs 1.16 mg/dL）や尿中アルブミン排泄（219 vs 179 mg/gCr）にもDTN投与期とFBX投与期で有意な違いは認められなかった．血漿BNP（48 vs 55 pg/mL）や血清高感度CRP（1.60 vs 1.41 mg/L）および酸化ストレスのマーカー（酸化LDL 94 vs 102 U/L, 活性酸素代謝物 339 vs 354 U.CARR）にも有意差はなかった．\n　CKD患者の高尿酸血症に対し，DTNはCKDステージG3bにおいても血清尿酸値を下げるのに効果的であり，心血管系危険因子に対する影響もFBXと同等であると考えられる．","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"Patients with chronic kidney disease（CKD）are at high risk for developing cardiovascular diseases and hyperuricemia is associated with the progression of renal dysfunction and the incidence of cardiovascular events. In this study, we compared the effects of dotinurad（DTN）, a novel selective urate reabsorption inhibitor, and febuxostat（FBX）, a non-purine xanthine oxidase inhibitor, on cardiovascular risk profile in CKD patients. Nineteen CKD patients were given DTN （0.5, 1, 2 mg/day） or FBX （10, 20, 40 mg/day） for 3-6 months in a random crossover manner, and the indices of cardiovascular risk were evaluated at the end of each treatment period. Hypouricemic effect was not significantly different between DTN and FBX （5.5 vs 5.1 mg/dL） even in subgroup subjects with glomerular filtration rate （eGFR）＜45 mL/min/1.73 m2（5.5 vs 4.9 mg/dL）There were no significant differences in blood pressure, hemoglobin A1c and serum lipids. Indices Indices of renal injury such as eGFR （51.9 vs 50.8 mL/min/ 1.73 m 2） and albuminuria （219 vs 179 mg/gCr） did not significantly differ between DTN and FBX. Significant differences were not observed in circulating markers of oxidative stress （oxidized LDL 94 vs 102 U/L, reactive oxygen metabolites 339 vs 354 U.CARR）or inflammation （high-sensitivity CRP 1.60 vs 1.41 mg/L）. Plasma brain natriuretic peptide did not show a significant difference between the two treatment periods （48 vs 55 pg/mL）. It is suggested that DTN has comparable hypouricemic effect to xanthine oxidase inhibitors even in stage G3b CKD patients and the effects on cardiovascular risk profile is also comparable to xanthine oxidase inhibitors.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"獨協医学会"}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AA00629581","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0385-5023","subitem_source_identifier_type":"PISSN"}]},"item_10001_text_33":{"attribute_name":"記事種別","attribute_value_mlt":[{"subitem_text_value":"原著"}]},"item_10001_version_type_20":{"attribute_name":"出版タイプ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"石光, 俊彦","creatorNameLang":"ja"},{"creatorName":"Ishimitsu, Toshihiko","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"本多, 勇晴","creatorNameLang":"ja"},{"creatorName":"Honda, Takeaki","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"高橋, 知里","creatorNameLang":"ja"},{"creatorName":"Takahashi, Chisato","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"横山, 翔平","creatorNameLang":"ja"},{"creatorName":"Yokoyama, Shohei","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"藤乘, 嗣泰","creatorNameLang":"ja"},{"creatorName":"Tojo, Akihiro","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"賴, 建光","creatorNameLang":"ja"},{"creatorName":"Rai, Tatemitsu","creatorNameLang":"en"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2024-04-22"}],"filename":"DJMS-50-1-9.pdf","filesize":[{"value":"818 KB"}],"format":"application/pdf","mimetype":"application/pdf","url":{"url":"https://dmu.repo.nii.ac.jp/record/2000027/files/DJMS-50-1-9.pdf"},"version_id":"c14433d6-9f67-4d5a-b8b3-49b392a0a131"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"高尿酸血症","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"URAT1","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"ドチヌラド","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"フェブキソスタット","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"慢性腎臓病","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"uric acid","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"hyperuricemia","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"URAT1","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"dotinurad","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"febuxostat","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"chronic kidney disease","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"高尿酸血症を呈する慢性腎臓病患者におけるドチヌラドとフェブキソスタットによる治療効果の比較","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"高尿酸血症を呈する慢性腎臓病患者におけるドチヌラドとフェブキソスタットによる治療効果の比較","subitem_title_language":"ja"},{"subitem_title":"Therapeutic Effects of Dotinurad and Febuxostat in Chronic Kidney Disease Patients with Hyperuricemia","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"14","path":["1693284379257"],"publish_date":"2023-09-13","publish_status":"0","recid":"2000027","relation_version_is_last":true,"title":["高尿酸血症を呈する慢性腎臓病患者におけるドチヌラドとフェブキソスタットによる治療効果の比較"],"weko_creator_id":"14","weko_shared_id":-1},"updated":"2024-04-22T07:07:59.446801+00:00"}