title: Allopurinol reduces cardiovascular risks and improves renal function in pre-dialysis chronic kidney disease patients with hyperuricemia.
abstract: To determine the effect of hyperuricemia and allopurinol therapy on renal functions in chronic kidney disease (CKD) stage 3-4, we studied 96 patients in stage 3-4 CKD (57% male, age 65.3 ± 12.4 years). The mean estimated glomerular filtration rate (GFR) was 44.62 ± 14.38 iriL/ min/1.73 m 2 . The study patients were divided into non-allopurinol users (n = 47) and those using allopurinol (n = 49) in the last 12 months. Serum uric acid (UA) and C-reactive protein levels decreased after allopurinol therapy (P = 0.00 and P = 0.04, respectively), but no change was observed in the control group during the study period. In the allopurinol group, the mean GFR increased 3.3 ±1.2 mL/min/1.73 m 2 /year, while it decreased 1.3 ± 0.6 mL/min/1.73 m 2 in the control group during the follow-up period (P = 0.04); the patients in the allopurinol group exhibited lower levels of serum potassium, serum low-density lipoprotein (LDL) and renal resistance index (RRI) (P-values were <0.05). The patients with stable renal functions or GFR change <10% (n = 25) at the end of 12 months had significantly lower LDL and RRI values and more allopurinol users than the group with decreasing GFR (74% vs. 48%, P <0.05). In the regression analysis, UA and RRI were found as independent variables (r 2 = 0.68, P <0.01; r 2 = 0.25, P <0.01) that affected loss of renal function. We conclude that our study suggests a role for allopurinol, an effective agent in lowering serum UA levels, as a reliable therapeutic option in controlling renal progression in pre-dialysis CKD patients.
authors.forename: Siren
authors.initials: S
authors.lastname: Sezer
authors.affiliation: Department of Nephrology, Baskent University, Ankara, Turkey.
authors.forename: Sebnem
authors.initials: S
authors.lastname: Karakan
authors.forename: Berna
authors.initials: B
authors.lastname: Atesagaoglu
authors.forename: F Nurhan Ozdemir
authors.initials: FN
authors.lastname: Acar
mesh_terms: D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use*; D000963:Antimetabolites / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000517:prevention & control; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D033461:Hyperuricemia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic; D012307:Risk Factors
chemical_list: D000963:Antimetabolites; D008078:Cholesterol, LDL; D000493:Allopurinol; D002097:C-Reactive Protein