Japanese Clinical Medicine

We evaluated the combination effect of the alkalizer citrate with the xanthine oxidase inhibitor allopurinol on renal function and uric acid in patients with hyperuricemia associated with obesity and/or metabolic syndrome (MetS), who were extracted from among the subjects enrolled in a prospective randomized controlled study aimed at assessing the efficacy of such a combination for improving renal function. We also conducted a post hoc analysis to examine influences on lipid profiles.

Patients who consented to participate in the study were randomly allocated to receive either allopurinol alone (monotherapy) or in combination with a citrate preparation (combination therapy). The analysis population consisted of 31 obese patients with a body mass index greater than 25 kg/m2 (monotherapy, 15 patients; combination therapy, 16 patients). The creatinine clearance rate (Ccr), serum uric acid levels, and lipid profiles were measured before and at 12 weeks after the start of treatment.

In the combination therapy group, Ccr increased significantly and serum uric acid levels decreased significantly in obese patients, while Ccr tended to increase and serum uric acid levels decreased, though not significantly, in patients with MetS-related clinical parameters. Overall, blood triglyceride levels tended to improve in the combination therapy group as compared with the monotherapy group.