Nephrol Dial Transplant (2003) 18: 603-606
© 2003 European Renal Association-European Dialysis and Transplant Association
Long-term efficacy of hyperuricaemia treatment in renal transplant patients
1 Hospital de Cruces, Rheumatology Section and Nephrology Division, Baracaldo, Pais Vasco, 2 Hospital de Gorliz, Rehabilitation Division, Gorliz, Pais Vasco and 3 Hospital Bellvitge, Rheumatology Division, Hospitalet, Barcelona, Spain
Background. Although hyperuricaemia and gout are frequently found in renal transplant recipients, little has been published on the efficacy of urate-lowering therapy (ULT) in this patient population. We therefore examine the effects of allopurinol and benziodarone therapy in a cohort of renal transplant patients.
Methods. We reviewed files from a cohort of 1328 patients that received renal transplantation. The selection criteria included: functioning allograft, hyperuricaemia for >12 months or gout, ULT lasting at least 1 year and at least two control measurements after the onset of ULT. Patients on azathioprine were treated with benziodarone to avoid azathioprine–allopurinol interactions.
Results. Two-hundred and seventy-nine patients fulfilled the criteria for review. They were treated with 289 courses of ULT: 100 with allopurinol (mean dose: 376 mg/day/dl/min of creatinine clearance) and 189 with benziodarone (mean dose: 73 mg/day). The mean follow-up was 38 months. Both drugs were effective for the control of hyperuricaemia, but benziodarone caused greater reductions in serum uric acid levels, especially when used at mean doses of >75 mg/day. Severe side effects were uncommon, in both the allopurinol and benziodarone groups.
Conclusions. Both allopurinol and benziodarone were effective for the control of hyperuricaemia in renal transplantation. Benziodarone at doses >75 mg/day was more effective than allopurinol in reducing serum uric acid levels and also reduced the risk of azathioprine–allopurinol interactions.
Keywords: allopurinol; benziodarone; hyperuricaemia; renal transplant patients; serum uric acid; urate-lowering therapy
Correspondence and offprint requests to: Dr F. Perez-Ruiz, Hospital de Cruces, Rheumatology Section, Baracaldo, Pais Vasco, Spain. Email: fperez{at}hcru.osakidetza.net
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