Clinical trial NCT04352153: Role of Uralyt-U in Patients With Hyperuricemia
Official title: A Randomized, Prospective, Controlled Study of the Efficacy and Safety of Uralyt-U Combined With Febuxostat in the Treatment of Hyperuricemia With Uric Acid Stones
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Uric Acid Stones
Hyperuricemia
Keywords: Uric Acid Stones
Hyperuricemia
Uralyt-U
Lead sponsor: Shanghai 10th People's Hospital
Sponsor class: OTHER
First posted: 2020-04-20
Enrollment: 102
Sex: ALL
Minimum age (years): 18
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of the study is to provide a more direct and objective basis for the widespread use of potassium sodium hydrogen citrate granules in the treatment of uric acid stones.

Detailed description: Hyperuricemia (HUA) is a common systemic metabolic disease. Its incidence is increasing year by year and more young people suffer from hyperuricemia. HUA can not only cause the onset of gouty arthritis, and then affect joint function, and even cause joint deformities. It can also cause damage to multiple organs such as the heart, brain, and kidney through multiple channels. Chronic kidney disease (CKD) refers to chronic kidney structural and dysfunction caused by various reasons. HUA is an independent risk factor that accelerates the progress of CKD. Studies have shown that lowering uric acid is another key treatment to delay the progress of CKD. A large number of studies have shown that the formation of uric acid crystals is the main mechanism of inducing renal injury.

In 2017, the "Multidisciplinary Expert Consensus for the Diagnosis and Treatment of Hyperuricemia-Related Diseases in China" recommended that patients with hyperuricemia receiving uric acid lowering drugs, especially those treated with uric acid excretion drugs and patients with uric acid nephrolithiasis, recommended that the pH of urine be adjusted during pH6.2 \~ 6.9 to increase the solubility of uric acid in urine. It is recommended to use sodium bicarbonate or potassium sodium citrate drugs to alkalinize urine, but it is not clear if there is any difference in the kinetic parameters of urine alkalinity, compliance rate of alkalinized urine and safety between sodium bicarbonate and potassium sodium citrate. No "head-to-head" clinical publications have been reported. This clinical trial was designed to evaluate the rate of alkalinization of urine, the therapeutic effect of renal lithiasis and adverse reactions between the sodium bicarbonate and potassium sodium hydrogen citrate granules in healthy people and patients with hyperuricemia and renal calculi (uric acid). This study provides a more direct and objective basis for the widespread use of potassium sodium hydrogen citrate granules in the treatment of uric acid stones.

Eligibility criteria: Inclusion Criteria:

* 18-70 years old, male, outpatient or inpatient;
* Acidic urinary stones
* Serum uric acid value ≥480 µmol / L;
* Other concomitant diseases (such as hypertension, hyperlipidemia, diabetes, etc.) are in a stable condition, and the dosage of other diseases is not changed during the test.
* eGFR≥30ml / min;

Exclusion Criteria:

* Pregnant or lactating women;
* Patients with acute or chronic renal failure (eGFR \<30ml / min);
* Patients with severe liver dysfunction (ALT, AST≥70 IU);
* In patients with uncontrolled hypertension, systolic blood pressure ≥160 and / or diastolic blood pressure ≥110mmHg;
* In uncontrolled diabetic patients, fasting blood glucose is\> 10mmol / L, and / or glycated hemoglobin is ≥9%;
* Patients that are taking atorvastatin, losartan, amlodipine, fenofibrate, pyrazinamide, tincture diuretics, thiazide diuretics, glucocorticoids, immunosuppressive agents and other drugs that affect uric acid excretion Drugs, those taking aspirin at a dose of\> 325mg / day;
* Cancer patients

Primary outcomes:
measure: Uric acid stones
timeFrame: 3 months
measure: Uric acid stones
timeFrame: 6 months
Secondary outcomes:
measure: Blood uric acid
timeFrame: 1 month
measure: Blood uric acid
timeFrame: 3 months
measure: Blood uric acid
timeFrame: 6 months
Other outcomes:
Locations:
city: Shanghai
country: China
facility: Department of Nephrolgoy, Shanghai 10th People's Hospital
state: Shanghai
Study officials:
affiliation: Shanghai 10th People's Hospital
name: Ai Peng, Ph.D., M.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Xue W, Cheng J, Zhao J, Wang L, Peng A, Liu X. Comparison potassium sodium hydrogen citrate with sodium bicarbonate in urine alkalization: a prospective crossover-controlled trial. Int Urol Nephrol. 2023 Jan;55(1):61-68. doi: 10.1007/s11255-022-03387-y. Epub 2022 Oct 19.