Allopurinol not linked to improved kidney damage biomarkers
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Allopurinol is not associated with improving biomarkers of kidney damage in patients with asymptomatic hyperuricemia and stage 3 chronic kidney disease, according to a published post-hoc analysis.
“[W]e found that allopurinol was not associated with improvement in biomarkers of kidney function or damage in patients with asymptomatic hyperuricemia and well-controlled hypertension and [diabetes mellitus] DM,” Loni Perrenoud, BS, of the division of renal diseases and hypertension in the department of medicine at the University of Colorado Anschutz Medical Campus in Aurora, Colorado, and colleagues wrote.
The analysis evaluated a previous double-blind, randomized, placebo-controlled study of 80 patients (aged 18 to 74 years old) with stage 3 CKD (eGFR between 30 mL/min/1.732 to 59 mL/min/1.732) and asymptomatic hyperuricemia (serum uric acid levels 7 mg/dL or more for men, 6 mg/dL or more for women). Patients were randomized to either receive allopurinol or a placebo during the 12-week study period (100 mg/day in the first week, 200 mg/day in the second week and 300 mg/day for weeks 3 through 12).
Of the 80 recruited patients, 70 completed study procedures and results showed allopurinol successfully lowered serum uric acid levels after 12 weeks with an estimate of -3.3mg/dL. Allopurinol did not improve vascular endothelial function or impact systemic or endothelial inflammation markers.
There was no significant correlation evaluated between baseline serum uric acid levels and urinary biomarkers of kidney damage, according to the study. Estimates for the change for allopurinol vs. the placebo during the study showed no significant change from baseline including albumin/creatinine ratio (1.09), neutrophil gelatinase-associated lipocalin (0.77), kidney injury molecule-1 or transforming growth factor-beta (2.36).
“Future studies to evaluate the potential effects of uric acid-lowering on CKD progression should include a larger number of patients at high risk of CKD progression and longer duration of follow-up,” the researchers wrote. “Additionally, future studies should consider the inclusion of patients at high risk of uric acid-related disease, such as those with an established history of gout.” – by Erin T. Welsh
Disclosures: The authors report no relevant financial disclosures.
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