@article{oai:dmu.repo.nii.ac.jp:00005087,
 author = {Kaiga, Akiko and Ishimitsu, Toshihiko and Satonaka, Hiroshi and Iwashima, Yoshio and Tojo, Akihiro},
 issue = {3},
 journal = {Dokkyo Journal of Medical Sciences},
 month = {Oct},
 note = {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. Allopurinol（Alp）, a xanthine oxidase inhibitor（XOi）, has been shown to improve the prognosis of CKD patients by inhibiting renal dysfunction and cardiovascular events. However, Alp possibly causes some serious side effects especially in patients with impaired renal function. Newer XOi such as febuxostat and topiroxostat（Tpx）can be safely used in CKD patients, while it has been reported that the incidence of cardiovascular death was rather higher in gout patients with cardiovascular diseases given febuxostat than those given Alp. In this study, we compared the effects of Alp and Tpx on cardiovascular risk profile in CKD patients. Thirty-five CKD patients were given Alp（50, 100, 200 mg/day）or Tpx（40, 80, 160 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 more prominent in Tpx than Alp（5.8 vs 6.4 mg/dL, p＝0.001）. There were significant differences in systolic blood pressure（Tpx 122 vs Alp 127 mmHg, p＝0.004）, serum creatinine（1.72 vs 1.93 mg/dL, p＝0.002）, plasma brain natriuretic peptide（43 vs 63 pg/mL, p＝0.022）, and the parameter of oxidative stress（reactive oxygen metabolite：314 vs 342 U.CARR, p＝0.010）. However, serum LDL-cholesterol（113 vs 102 mg/dL, p＝0.008）were significantly higher in Tpx than in Alp. Although attention should be paid to the effects on serum lipid profile, Tpx is supposedly more effective in inhibiting cardiovascular disorders and slowing the progression of renal dysfunction in hyperuricemic CKD patients.},
 pages = {171--181},
 title = {Therapeutic Effects of Allopurinol and Topiroxostat in Chronic Kidney Disease Patients with Hyperuricemia},
 volume = {48},
 year = {2021}
}