title: Clinical outcome of hyperuricemia in IgA nephropathy: a retrospective cohort study and randomized controlled trial.
abstract: BACKGROUND
  Hyperuricemia is an independent risk factor for renal progression in IgA nephropathy (IgAN). However, no study has evaluated the effect of allopurinol on the clinical outcome in hyperuricemic IgAN.
  
  
  METHODS
  First,a retrospective cohort study of 353 IgAN patients was conducted to explore the relationship between uric acid (UA) and the progression of renal disease over a mean period of 5 years. Then, 40 hyperuricemic IgAN patients were randomized to receive allopurinol (100-300 mg/day) or usual therapy for 6 months. The study outcomes were renal disease progression and/or blood pressure.
  
  
  RESULTS
  Hyperuricemia independently predicted renal survival at 1, 3, and 5 years after adjustment for different baseline estimated glomerular filtration rates. In the randomized controlled trial, allopurinol did not significantly alter renal progression or proteinuria. The antihypertensive drug dosage was reduced in 7 of 9 cases with hypertension in the allopurinol group compared to 0 of 9 cases in the control group (p < 0.01). UA levels correlated with mean arterial pressure in normotensive patients (r = 0.388, p < 0.001).
  
  
  CONCLUSIONS
  Hyperuricemia predicts the progression of IgAN independently of baseline estimated glomerular filtration rate. Allopurinol may improve the control of blood pressure. Further studies are required to explore the effects of lowering UA on renal protection in IgAN.
authors: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Yongjun
authors: Y
authors: Shi
authors: Wei
authors: W
authors: Chen
authors: Diana
authors: D
authors: Jalal
authors: Zhibin
authors: Z
authors: Li
authors: Wenfang
authors: W
authors: Chen
authors: Haiping
authors: H
authors: Mao
authors: Qiongqiong
authors: Q
authors: Yang
authors: Richard J
authors: RJ
authors: Johnson
authors: Xueqing
authors: X
authors: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D033461:Hyperuricemia / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000493:Allopurinol