Losartan sebagai Regimen Penurun Serum Asam Urat pada Penderita Gout dengan Hipertensi:
DOI:
https://doi.org/10.29303/jku.v11i3.739Keywords:
Losartan, asam urat, hipertensi, urikosurikAbstract
Asam urat (AU) merupakan produk akhir dari metabolisme purin yang terdistribusi pada plasma dan cairan synovial. Solubilitas AU pada air sangat rendah, sehingga pada konsentrasi 6.8 mg/dL dapat membentuk kristal, yaitu monosodium urat. Kristal yang mengendap di sendi dapat memicu proses inflammasi yang disebut dengan gout artritis (GA). Penatalaksanaan GA yang tidak optimal menyebabkan penurunan kualitas hidup yang signifikan. Losartan merupakan obat hipertensi yang bekerja dengan memblokade reseptor Angiotensin I, sekaligus memiliki efek menurunkan kadar AU. Losartan diduga menghambat transporter URAT1 pada tubulus ginjal, sehingga menganggu reabsorbsi AU dan menyebabkan efek urikosurik. Tinjauan ini akan membahas potensi Losartan sebagai regimen terapi penurun AU pada penderita gout dengan hipertensi.
References
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28. Kamper AL, Nielsen AH. Uricosuric effect of losartan in patients with renal transplants. Transplantation. 2001 Aug 27;72(4):671–4.
29. Bryant CE, Rajai A, Webb NJA, Hogg RJ. Effects of losartan and enalapril on serum uric acid and GFR in children with proteinuria. Pediatr Nephrol. 2021 Oct 1;36(10):3211–9.
30. Miao Y, Ottenbros SA, Laverman GD, Brenner BM, Cooper ME, Parving HH, et al. Effect of a reduction in uric acid on renal outcomes during losartan treatment: A post hoc analysis of the reduction of endpoints in non-insulin-dependent diabetes mellitus with the angiotensin ii antagonist losartan trial. Hypertension. 2011;58(1):2–7.
31. Hamada T, Ichida K, Hosoyamada M, Mizuta E, Yanagihara K, Sonoyama K, et al. Uricosuric action of losartan via the inhibition of urate transporter 1 (URAT 1) in hypertensive patients. Am J Hypertens. 2008;21(10):1157–62.
32. Sun H, Qu Q, Qu J, Lou XY, Peng Y, Zeng Y, et al. URAT1 gene polymorphisms influence uricosuric action of losartan in hypertensive patients with hyperuricemia. Pharmacogenomics. 2015;16(8):855–63.
2. Dehlin M, Jacobsson L, Roddy E. Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors. Nat Rev Rheumatol. 2020;16(7):380–90.
3. Perhimpunan Reumatologi Indonesia. Rekomendasi Pedoman Diagnosis dan Pengelolaan Gout. 2018. 1–33 p.
4. Chandratre P, Roddy E, Clarson L, Richardson J, Hider SL, Mallen CD. Health-related quality of life in gout: a systematic review. Rheumatology (Oxford). 2013/08/11. 2013 Nov;52(11):2031–40.
5. Enna SJ, Bylund DB. Losartan. xPharm Compr Pharmacol Ref. 2022 Feb 9;1–2.
6. Sutton Burke EM, Kelly TC, Shoales LA, Nagel AK. Angiotensin Receptor Blockers Effect on Serum Uric Acid—A Class Effect? J Pharm Pract. 2020;33(6):874–81.
7. Maiuolo J, Oppedisano F, Gratteri S, Muscoli C, Mollace V. Regulation of uric acid metabolism and excretion. Int J Cardiol. 2016;213:8–14.
8. Furuhashi M. New insights into purine metabolism in metabolic diseases: Role of xanthine oxidoreductase activity. Am J Physiol - Endocrinol Metab. 2020;319(5):E827–34.
9. Hyndman D, Liu S, Miner JN. Urate Handling in the Human Body. Curr Rheumatol Rep. 2016;18(6).
10. Skoczy?ska M, Chowaniec M, Szymczak A, Langner-hetma?czuk A, Maci??ek-chyra B, Wiland P. Pathophysiology of hyperuricemia and its clinical significance – a narrative review. Reumatologia. 2020;58(5):312–23.
11. George C, Minter DA. Hyperuricemia. Urol a Glance. 2021 Jul 20;107–9.
12. Ragab G, Elshahaly M, Bardin T. Gout?: An old disease in new perspective – A review. J Adv Res. 2017;8(5):495–511.
13. Kopke A, Greef O. Hyperuricaemia and gout. South African Fam Pract. 2015;57(1):6–12.
14. Kementerian Kesehatan Republik Indonesia. Panduan Praktik Klinis Bagi Dokter di Fasilitas Pelayanan Primer Edisi II. Mentri Kesehat Republik Indones. 2014;150.
15. Hainer BL, Matheson E, Travis Wilkes R. Diagnosis, treatment, and prevention of gout. Am Fam Physician. 2014;90(12):831–6.
16. Bach MH, Simkin PA. Uricosuric drugs: the once and future therapy for hyperuricemia? Curr Opin Rheumatol. 2014 Mar;26(2):169–75.
17. Chen RJ, Suchard MA, Krumholz HM, Schuemie MJ, Shea S, Duke J, et al. Comparative First-Line Effectiveness and Safety of ACE (Angiotensin-Converting Enzyme) Inhibitors and Angiotensin Receptor Blockers: A Multinational Cohort Study. Hypertension. 2021;(September):591–603.
18. Hill RD, Vaidya PN. Angiotensin II Receptor Blockers (ARB). StatPearls. 2022 Mar 28;
19. Bhardwaj G. How the antihypertensive losartan was discovered. Expert Opin Drug Discov. 2006;1:609–18.
20. Abraham HMA, White CM, White WB. The Comparative Efficacy and Safety of the Angiotensin Receptor Blockers in the Management of Hypertension and Other Cardiovascular Diseases. Drug Saf. 2015;38(1):33–54.
21. Dézsi CA. The different therapeutic choices with ARBs. Which one to give? When? Why? Am J Cardiovasc Drugs. 2016;16(4):255–66.
22. Wolff ML, Cruz JL, Vanderman AJ, Brown JN. The effect of angiotensin II receptor blockers on hyperuricemia. Ther Adv Chronic Dis. 2015;6(6):339–46.
23. Nishida Y, Takahashi Y, Susa N, Kanou N, Nakayama T, Asai S. Comparative effect of angiotensin II type I receptor blockers on serum uric acid in hypertensive patients with type 2 diabetes mellitus: A retrospective observational study. Cardiovasc Diabetol. 2013;12(1):1–8.
24. Nakamura M, Sasai N, Hisatome I, Ichida K. Effects of irbesartan on serum uric acid levels in patients with hypertension and diabetes. Clin Pharmacol. 2014 May 2;6(1):79.
25. Dang A, Zhang Y, Liu G, Chen G, Song W, Wang B. Effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia in Chinese population. J Hum Hypertens. 2006;20(1):45–50.
26. Würzner G, Gerster JC, Chiolero A, Maillard M, Fallab-Stubi CL, Brunner HR, et al. Comparative effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia and gout. J Hypertens. 2001;19(10):1855–60.
27. Fan Y, Wei F, Lang Y, Wang S. Losartan treatment for hypertensive patients with hyperuricaemia in Chinese population: Ameta-analysis. J Hypertens. 2015;33(4):681–9.
28. Kamper AL, Nielsen AH. Uricosuric effect of losartan in patients with renal transplants. Transplantation. 2001 Aug 27;72(4):671–4.
29. Bryant CE, Rajai A, Webb NJA, Hogg RJ. Effects of losartan and enalapril on serum uric acid and GFR in children with proteinuria. Pediatr Nephrol. 2021 Oct 1;36(10):3211–9.
30. Miao Y, Ottenbros SA, Laverman GD, Brenner BM, Cooper ME, Parving HH, et al. Effect of a reduction in uric acid on renal outcomes during losartan treatment: A post hoc analysis of the reduction of endpoints in non-insulin-dependent diabetes mellitus with the angiotensin ii antagonist losartan trial. Hypertension. 2011;58(1):2–7.
31. Hamada T, Ichida K, Hosoyamada M, Mizuta E, Yanagihara K, Sonoyama K, et al. Uricosuric action of losartan via the inhibition of urate transporter 1 (URAT 1) in hypertensive patients. Am J Hypertens. 2008;21(10):1157–62.
32. Sun H, Qu Q, Qu J, Lou XY, Peng Y, Zeng Y, et al. URAT1 gene polymorphisms influence uricosuric action of losartan in hypertensive patients with hyperuricemia. Pharmacogenomics. 2015;16(8):855–63.
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Published
2022-10-28
How to Cite
Pribadi, F., Panggabean, R. T. M. ., Raga, A. D., Maheswari, E. Y., Wakas, B. E., Syahda, A. F., Adriani, L., & Luke, K. (2022). Losartan sebagai Regimen Penurun Serum Asam Urat pada Penderita Gout dengan Hipertensi:. Jurnal Kedokteran, 11(3), 1028–1032. https://doi.org/10.29303/jku.v11i3.739
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Literature Review
