Siu 20066767 Siu YP, Leung KT, Tong MK, Kwan TH. Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis. 2006 Jan;47(1):51-9.
|
54 |
Patients with hyperuricemia and CKD |
Allopurinol |
12m |
Allopurinol helps preserve kidney function during 12 months of therapy compared with controls |
Goicoechea 20106868 Goicoechea M, Vinuesa SG, Verdalles U, Ruiz-Caro C, Ampuero J, Rincón A, et al. Effect of allopurinol in chronic kidney disease progression and cardiovascular risk. Clin J Am Soc Nephrol. 2010 Aug;5(8):1388-93.
|
113 |
Patients with CKD |
Allopurinol vs Controls |
24m |
Allopurinol decreased C-reactive protein and delayed the progression of renal impairment in patients with chronic kidney disease |
Hosoya 20146969 Hosoya T, Ohno I, Nomura S, Hisatome I, Uchida S, Fujimori S, et al. Effects of topiroxostat on the serum urate levels and urinary albumin excretion in hyperuricemic stage 3 chronic kidney disease patients with or without gout. Clin Exp Nephrol. 2014 Dec;18(6):876-84.
|
123 |
Patients aged 20–75 years, with hyperuricemia and CKD stages 2-3 |
Topiroxostat vs Placebo |
5.5m |
Changes in eGFR were not significantly different between topiroxostat and placebo groups |
Sircar 20157070 Sircar D, Chatterjee S, Waikhom R, Golay V, Raychaudhury A, Chatterjee S, et al. Efficacy of febuxostat for slowing the GFR decline in patients with CKD and asymptomatic hyperuricemia: a 6-month, double-blind, randomized, placebo-controlled trial. Am J Kidney Dis. 2015 Dec;66(6):945-50.
|
93 |
Patients with CKD stages 3-4 |
Febuxostat vs Placebo |
6m |
Febuxostat significantly decrease the decline in eGFR compared to placebo |
Xuemei Liu 20187171 Liu X, Zhai T, Ma R, Luo C, Wang H, Liu L. Effects of uric acid-lowering therapy on the progression of chronic kidney disease: a systematic review and meta-analysis. Ren Fail. 2018 Nov;40(1):289-97.
|
832 |
Meta-analysis: 12 RCTs |
Allopurinol or Febuxostat |
4-24m |
The risk of worsening of kidney function or ESRD or death was significantly decreased in the treatment group compared to the control group |
Kimura 20187272 Kimura K, Hosoya T, Uchida S, Inaba M, Makino H, Maruyama S, et al. Febuxostat therapy for patients with stage 3 ckd and asymptomatic hyperuricemia: a randomized trial. Am J Kidney Dis. 2018 Dec;72(6):798-810.
|
443 |
Japanese patients with stage 3 CKD and asymptomatic hyperuricemia |
Febuxostat vs placebo |
27m |
Febuxostat did not mitigate the decline in kidney function |
Lee 20197373 Lee JW, Lee KH. Comparison of renoprotective effects of febuxostat and allopurinol in hyperuricemic patients with chronic kidney disease. Int Urol Nephrol. 2019 Mar;51(3):467-73.
|
141 |
Patients with hyperuricemia and CKD stage 3 |
Febuxostat vs Allopurinol |
5y |
Febuxostat reduced serum uric acid level and delayed CKD progression more effectively than allopurinol |
Badve 20206060 Badve SV, Pascoe EM, Tiku A, Boudville N, Brown FG, Cass A, et al. Effects of allopurinol on the progression of chronic kidney disease. N Engl J Med. 2020 Jun;382(26):2504-13.
|
363 |
Patients with stage 3-4 CKD and no history of gout who had a urinary albumin:creatinine ratio≥265 or an eGFR decrease of at least 3.0 mL/min/1.73 m2 in the preceding year |
Allopurinol vs Placebo |
26m |
Allopurinol did not significantly slow the decline in eGFR compared with placebo |
Doria 20205959 Doria A, Galecki AT, Spino C, Pop-Busui R, Cherney DZ, Lingvay I, et al. Serum urate lowering with allopurinol and kidney function in type 1 diabetes. N Engl J Med. 2020 Jun;382(26):2493-503.
|
530 |
Patients with type 1 diabetes, SUA>4.5mg/dL, and eGFR40~99mL/min/1.73 m2 |
Allopurinol vs Placebo |
38m |
No significant differences in CKD progression between allopurinol and placebo were observed |
Hsu 20207474 Hsu YO, Wu IW, Chang SH, Lee CC, Tsai CY, Lin CY, et al. Comparative Renoprotective Effect of Febuxostat and Allopurinol in Predialysis Stage 5 Chronic Kidney Disease Patients: A Nationwide Database Analysis. Clin Pharmacol Ther. 2020;107(5):1159-69.
|
6057 |
Patients with stage 5 CKD prescribed either febuxostat or allopurinol |
Febuxostat vs Allopurinol |
4y |
Febuxostat decreased the rate of progression to dialysis |
Sezai 20207575 Sezai A, Unosawa S, Taoka M, Osaka S, Sekino H, Tanaka M. Changeover Trial of Febuxostat and Topiroxostat for Hyperuricemia with Cardiovascular Disease: Sub-Analysis for Chronic Kidney Disease (TROFEO CKD Trial). Ann Thorac Cardiovasc Surg. 2020;26(4):202-8.
|
55 |
Patients with CKD stage 3-4 |
Febuxostat vs Topiroxostat |
1y |
Febuxostat had stronger renoprotective and antioxidant effects than topiroxostat |