Please use this identifier to cite or link to this item:
Scopus Web of Science® Altmetric
Type: Journal article
Title: Effects of uric acid-lowering therapy on renal outcomes: a systematic review and meta-analysis
Author: Bose, B.
Badve, S.
Hiremath, S.
Boudville, N.
Brown, F.
Cass, A.
De Zoysa, J.
Fassett, R.
Faull, R.
Harris, D.
Hawley, C.
Kanellis, J.
Palmer, S.
Perkovic, V.
Pascoe, E.
Rangan, G.
Walker, R.
Walters, G.
Johnson, D.
Citation: Nephrology Dialysis Transplantation, 2014; 29(2):406-413
Publisher: Oxford University Press
Issue Date: 2014
ISSN: 0931-0509
Statement of
Bhadran Bose, Sunil V. Badve, Swapnil S. Hiremath, Neil Boudville, Fiona G. Brown, Alan Cass, Janak R. de Zoysa, Robert G. Fassett, Randall Faull, David C. Harris, Carmel M. Hawley, John Kanellis, Suetonia C. Palmer, Vlado Perkovic, Elaine M. Pascoe, Gopala K. Rangan, Robert J. Walker, Giles Walters, and David W. Johnson
Abstract: Background: Non-randomized studies suggest an association between serum uric acid levels and progression of chronic kidney disease (CKD). The aim of this systematic review is to summarize evidence from randomized controlled trials (RCTs) concerning the benefits and risks of uric acid-lowering therapy on renal outcomes. Methods: Medline, Excerpta Medical Database and Cochrane Central Register of Controlled Trials were searched with English language restriction for RCTs comparing the effect of uric acid-lowering therapy with placebo/no treatment on renal outcomes. Treatment effects were summarized using random-effects meta-analysis. Results: Eight trials (476 participants) evaluating allopurinol treatment were eligible for inclusion. There was substantial heterogeneity in baseline kidney function, cause of CKD and duration of follow-up across these studies. In five trials, there was no significant difference in change in glomerular filtration rate from baseline between the allopurinol and control arms [mean difference (MD) 3.1 mL/min/1.73 m², 95% confidence intervals (CI) -0.9, 7.1; heterogeneity χ2=1.9, I²=0%, P=0.75]. In three trials, allopurinol treatment abrogated increases in serum creatinine from baseline (MD -0.4 mg/dL, 95% CI -0.8, -0.0 mg/dL; heterogeneity χ2=3, I²=34%, P=0.22). Allopurinol had no effect on proteinuria and blood pressure. Data for effects of allopurinol therapy on progression to end-stage kidney disease and death were scant. Allopurinol had uncertain effects on the risks of adverse events. Conclusions: Uric acid-lowering therapy with allopurinol may retard the progression of CKD. However, adequately powered randomized trials are required to evaluate the benefits and risks of uric acid-lowering therapy in CKD.
Keywords: Chronic kidney disease; clinical trial; kidney function test; renal dialysis; uric acid
Rights: © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
DOI: 10.1093/ndt/gft378
Grant ID:
Appears in Collections:Aurora harvest 7
Medicine publications

Files in This Item:
There are no files associated with this item.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.