Effects of irbesartan on serum uric acid levels in patients with hypertension and diabetes

Makiko Nakamura,1 Nobuo Sasai,2 Ichiro Hisatome,3 Kimiyoshi Ichida11Department of Pathophysiology, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan; 2Sasai Clinic, Kanagawa, Japan; 3Division of Regenerative Medicine and Therapeutics, Institute of Regenerative Medicine and Biofunction, G...

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Autores principales:	Nakamura M, Sasai N, Hisatome I, Ichida K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/5c55511bf0884c1e9c5dce75ba44ac81
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spelling	oai:doaj.org-article:5c55511bf0884c1e9c5dce75ba44ac812021-12-02T06:29:19ZEffects of irbesartan on serum uric acid levels in patients with hypertension and diabetes1179-1438https://doaj.org/article/5c55511bf0884c1e9c5dce75ba44ac812014-05-01T00:00:00Zhttp://www.dovepress.com/effects-of-irbesartan-on-serum-uric-acid-levels-in-patients-with-hyper-a16629https://doaj.org/toc/1179-1438 Makiko Nakamura,1 Nobuo Sasai,2 Ichiro Hisatome,3 Kimiyoshi Ichida11Department of Pathophysiology, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan; 2Sasai Clinic, Kanagawa, Japan; 3Division of Regenerative Medicine and Therapeutics, Institute of Regenerative Medicine and Biofunction, Graduate School of Medical Sciences, Tottori University, Tottori, JapanBackground: Hyperuricemia has been proposed to be a risk factor for cardiovascular disease and chronic kidney disease. Since diabetes is often complicated by hypertension and hyperuricemia, efficient therapeutic strategy against these two complications is very important in diabetic treatment. It has been reported that the antihypertensive drug, irbesartan, inhibits the renal uric acid reabsorptive transporters, URAT1 and GLUT9; this result suggests that irbesartan decreases serum uric acid level (SUA).Subjects and methods: A retrospective study of 107 patients with hypertension and diabetes was performed to analyze the effects of irbesartan on blood pressure, estimated glomerular filtration rate (eGFR), and SUA. The follow-up period was 6–12 months. Seventy percent of the patients were diagnosed with diabetic nephropathy stage II–IV. We excluded patients treated with drugs that influenced SUA. The multiple logistic regression analysis was introduced to identify the relative factors for SUA decline. The time-dependent SUA changes were examined in a mixed-linear model.Results: Irbesartan reduced blood pressure significantly after 1, 6, and 12 months’ treatment. No subject showed significant change in eGFR from baseline level throughout the period. The multiple logistic regression analysis revealed that SUA baseline significantly influenced SUA decline after 6–12 months. In patients whose SUA baseline was ≥5.9 mg/dL, the SUA was significantly decreased from 6.6±0.16 mg/dL to 6.2±0.16 mg/dL (P=0.010), after 12 months’ irbesartan treatment. In the SUA baseline <5.9 mg/dL group, the SUA did not show significant change over the monitoring period.Conclusion: Our results demonstrate that irbesartan reduces the risk of hyperuricemia. No decline in renal function was observed after the initiation of irbesartan treatment. The present report determines the criteria of SUA baseline for introducing an antihyperuricemic effect using irbesartan. Its antihypertensive effect coupled with SUA decline would be effective for the treatment of hypertension complicated by hyperuricemia.Keywords: angiotensin-receptor blocker, diabetes, hypertension, hyperuricemia, serum uric acidNakamura MSasai NHisatome IIchida KDove Medical PressarticleTherapeutics. PharmacologyRM1-950ENClinical Pharmacology: Advances and Applications, Vol 2014, Iss default, Pp 79-86 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Therapeutics. Pharmacology RM1-950
spellingShingle	Therapeutics. Pharmacology RM1-950 Nakamura M Sasai N Hisatome I Ichida K Effects of irbesartan on serum uric acid levels in patients with hypertension and diabetes
description	Makiko Nakamura,1 Nobuo Sasai,2 Ichiro Hisatome,3 Kimiyoshi Ichida11Department of Pathophysiology, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan; 2Sasai Clinic, Kanagawa, Japan; 3Division of Regenerative Medicine and Therapeutics, Institute of Regenerative Medicine and Biofunction, Graduate School of Medical Sciences, Tottori University, Tottori, JapanBackground: Hyperuricemia has been proposed to be a risk factor for cardiovascular disease and chronic kidney disease. Since diabetes is often complicated by hypertension and hyperuricemia, efficient therapeutic strategy against these two complications is very important in diabetic treatment. It has been reported that the antihypertensive drug, irbesartan, inhibits the renal uric acid reabsorptive transporters, URAT1 and GLUT9; this result suggests that irbesartan decreases serum uric acid level (SUA).Subjects and methods: A retrospective study of 107 patients with hypertension and diabetes was performed to analyze the effects of irbesartan on blood pressure, estimated glomerular filtration rate (eGFR), and SUA. The follow-up period was 6–12 months. Seventy percent of the patients were diagnosed with diabetic nephropathy stage II–IV. We excluded patients treated with drugs that influenced SUA. The multiple logistic regression analysis was introduced to identify the relative factors for SUA decline. The time-dependent SUA changes were examined in a mixed-linear model.Results: Irbesartan reduced blood pressure significantly after 1, 6, and 12 months’ treatment. No subject showed significant change in eGFR from baseline level throughout the period. The multiple logistic regression analysis revealed that SUA baseline significantly influenced SUA decline after 6–12 months. In patients whose SUA baseline was ≥5.9 mg/dL, the SUA was significantly decreased from 6.6±0.16 mg/dL to 6.2±0.16 mg/dL (P=0.010), after 12 months’ irbesartan treatment. In the SUA baseline <5.9 mg/dL group, the SUA did not show significant change over the monitoring period.Conclusion: Our results demonstrate that irbesartan reduces the risk of hyperuricemia. No decline in renal function was observed after the initiation of irbesartan treatment. The present report determines the criteria of SUA baseline for introducing an antihyperuricemic effect using irbesartan. Its antihypertensive effect coupled with SUA decline would be effective for the treatment of hypertension complicated by hyperuricemia.Keywords: angiotensin-receptor blocker, diabetes, hypertension, hyperuricemia, serum uric acid
format	article
author	Nakamura M Sasai N Hisatome I Ichida K
author_facet	Nakamura M Sasai N Hisatome I Ichida K
author_sort	Nakamura M
title	Effects of irbesartan on serum uric acid levels in patients with hypertension and diabetes
title_short	Effects of irbesartan on serum uric acid levels in patients with hypertension and diabetes
title_full	Effects of irbesartan on serum uric acid levels in patients with hypertension and diabetes
title_fullStr	Effects of irbesartan on serum uric acid levels in patients with hypertension and diabetes
title_full_unstemmed	Effects of irbesartan on serum uric acid levels in patients with hypertension and diabetes
title_sort	effects of irbesartan on serum uric acid levels in patients with hypertension and diabetes
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/5c55511bf0884c1e9c5dce75ba44ac81
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_version_	1718399871328714752

Effects of irbesartan on serum uric acid levels in patients with hypertension and diabetes

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