Table 1.
Randomized controlled trials of uric acid-lowering therapy for the recovery of renal function.
| Study | At risk | Uric acid-lowering therapy | Finding on kidney function | Limitations |
|---|---|---|---|---|
| Siu et al. [63] (2006) | SCr 1.35–4.50 mg/dL (n = 54) | 12 months of allopurinol | Slowed progression of CKD | Limited by the concomitant use of antihypertensive drugs |
| Kanbay et al. [67] (2007) | eGFR > 60 mL/min (n = 69) | 3 months of allopurinol | Increased eGFR from 79 to 92 mL/min | Small sample size and relatively short follow-up |
| Goicoechea et al. [64] (2010) | CKD 3 (n = 113) | 24 months of allopurinol | Slowed decline in eGFR | Not designed in a double-blinded fashion, all patients were advised about the dietary composition, concomitant use of statins, antiplatelet, and RAAS blocker drugs. |
| Momeni et al. [68] (2010) | T2DM (SCr < 3.0 mg/dL) (n = 40) | 4 months of allopurinol | Reduced proteinuria | Small sample size and relatively short follow-up |
| Pai et al. [69] (2013) | CKD 3, 4 (n = 183) | 2 years of allopurinol | Reduced blood pressure and progression of CKD | Not designed in a randomized control, double-blinded fashion. Limited by the concomitant use of statins, antiplatelet and RAAS blocker drugs. |
| Sezer et al. [70] (2014) | CKD (n = 96) | 6 months of allopurinol | Decrease in GFR in control patients | Patients were advised about the dietary composition of their food. |
| Sircar et al. [62] (2015) | CKD 3, 4 (n = 93) | 6 months of febuxostat | Slowed the decline in eGFR | Small sample size and short duration of follow-up, a relatively homogeneous population. |
| Chou et al. [66] (2018) | CKD (n = 874) | Treatment with either allopurinol, febuxostat, or benzbromarone | Lower risk of ESRD with febuxostat or benzbromarone | Single tertiary medical center, differential prescription practices for urate-lowering agents, insufficient to yield statistically reliable information |
| Yu et al. [65] (2018) | eGFR 20–60 mL/min (n = 66) | 6 months of febuxostat or benzbromarone | Maintain renal function | Open-labeled, small sample size and relatively short follow-up |
| Kimura et al. [61] (2018) | CKD 3 (n = 467) | 108 weeks of febuxostat | NO decline in kidney function | GFR was estimated rather than measured, and patients with stages 4 and 5 CKD were excluded. |
| Liu et al. [71] (2019) | CKD 3–5 (n = 208) | 6 months of febuxostat or allopurinol | Slowed progression of renal function | Small sample size, few female patients, and short duration of follow-up |
SCr, serum creatinine; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; RAAS, renin-angiotensin-aldosterone system; T2DM, type 2 diabetes mellitus; GFR, glomerular filtration rate; ESRD, end-stage renal disease.