Table 1.
Randomized controlled trials lowering serum uric acid and its effect on renal function.
| Study (Primary author and year) | Population | Intervention | Results |
|---|---|---|---|
| Gibson et al. (1982) [29] | 59 patients with primary gout | Colchicine and allopurinol versus colchicine alone | Retarded an apparent decline of renal function over 2 years |
| Chanard et al. (2003) [30] | 48 renal transplant patients with hypertension, on cyclosporine | Amlodipine or tertatolol | Amlodipine decreased serum uric acid levels and increased glomerular filtration rate as compared with tertatolol |
| Siu et al. (2006) [20] | 54 hyperuricemic patients with CKD | Allopurinol versus standard therapy | No significant differences but a trend toward a lower serum creatinine level in the treatment group compared with controls after 12 months of therapy |
| Liu and Sheng (2007) [31] | 47 hyperuricemic patients with CKD | Allopurinol versus standard therapy | Serum creatinine was lower in the allopurinol group and the rate of renal function deterioration was significantly decreased over 12 months |
| Kanbay et al. (2007) [32] | 59 patients | Allopurinol given to the hyperuricemic patients and no uric acid lowering therapy for the normouricemic patients | Allopurinol therapy significantly improved GFR but proteinuria was unchanged |
| Malaguarnera et al. (2009) [33] | 38 elderly patients with hyperuricemia | Rasburicase versus placebo | Significant reduction in creatinine and an increase in creatinine clearance over 2 months |
| Goicoechea et al. (2010) [22] | 113 patients with estimated GFR <60 mL/min | Allopurinol versus standard therapy (no uric acid lowering therapy) | Allopurinol treatment slowed down renal disease progression independent of age, gender, diabetes, C-reactive protein, albuminuria and renin-angiotensin blocker use over 24 months |
| Momeni et al. (2010) [34] | 40 patients with type 2 diabetes mellitus and diabetic nephropathy (proteinuria of 500 mg/day and serum creatinine level <3 mg/dL) | Allopurinol versus placebo | Allopurinol reduced severity of proteinuria after 4 months of drug administration. No change in creatinine was noted |
| Whelton et al. (2011) [35] | 116 hyperuricemic patients (post hoc) | Febuxostat in 40, 80 or 120 mg doses | Improvement or maintenance of estimated GFR was inversely correlated with the quantitative reduction in serum uric acid from baseline over 5 years |
| Shi et al. (2012) [36] | 40 hyperuricemic patients with IgA nephropathy | Allopurinol versus standard therapy | Hyperuricemia predicted progression of IgA nephropathy independently of baseline estimated GFR over 6 months. No change in renal progression or proteinuria was noted |
| Pai et al. (2013) [37] | 183 hyperuricemic patients with CKD | Allopurinol versus standard therapy (no uric acid lowering therapy) | Allopurinol was associated with decreased progression of renal disease in CKD |
| Sircar et al. (2015) [38] | 93 hyperuricemic patients with CKD 3 and 4 | Febuxostat versus placebo | Febuxostat slowed the decline in estimated GFR in CKD stages 3 and 4 compared to placebo |