Allopurinol effects on diastolic dysfunction in ESRD patients with hyperuricemia
2011
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Background: The role of reactive oxygen
species (ROS) in the pathogenesis
of different cardiac diseases has been documented. Recently, effect of
allopurinol in decreasing the production of ROS and
improving cardiovascular pathogenesis has come into scientific interest. Animal
studies have documented the benefit of allopurinol in improving left
ventricular dilatation, hypertrophy and fibrosis, and myocardial contractility
and in the prevention of systemic vasoconstriction. The aim of this study was
to evaluate the effect of allopurinol in improving diastolic dysfunction in ESRD
patients with hyperuricemia. Methods : This was an interventional study on 28 patients
(19 males and 9 females)
with ESRD and hyperuricemia. At the end of a one-month
course of allopurinol therapy (100 mg daily),
echocardiographic indices of diastolic dysfunction were measured and compared
to the baseline indices. Results : The mean level of uric acid was 7.5±0.96 mg/dl. The
mean EF before and after the study were %44.28±%9.8
and %44.64±%9.7, (no significant difference),
Respectively. The two indices of IVCT and
A reversal were shown to have significant
improvement after therapy (p=0.028 and 0.012,
respectively). The grading of diastolic dysfunction didn't improve
significantly after treatment with allopurinol. Conclusion: Significant
improvement in some of studied indices, reproduced only in male subgroup of
patients that might be related to a better response of males to allopurinol,
however, a longer course of treatment may result in more favorable responses.
Better patient selection in terms of "EF"s
with normal distribution and repeating the study in non-dialysis hyperuricemic
patients may result in more accurate information.
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