Assessment of allopurinol use in patients with chronic kidney disease and asymptomatic hyperuricemia: a retrospective cohort study.

INTRODUCTION

Asymptomatic hyperuricemia (AH) is common in patients with chronic kidney disease (CKD) and has been identified as a modifiable condition. Addressing it could increase the possibilities for preventing and treating kidney injury.

OBJECTIVE

To assess whether administering allopurinol to people with chronic kidney disease and asymptomatic hyperuricemia enhances kidney function and delays progression to kidney failure.

METHODS

This is a retrospective cohort study with data collection from medical records at a specialized center from 2006 to 2020. Eighty people in stages 3 and 4 of CKD with AH were divided into two groups: 40 patients received allopurinol and 40 did not receive medication. Patients were followed for 24 months, with four consultations. Serum uric acid levels and creatinine-based estimated glomerular filtration rate (eGFRcr), estimated by the CKD-EPI formula, were compared within groups and between groups using mean, standard deviation, and analysis of variance (ANOVA).

RESULTS

Eighty patients were included in the study. Comparing 40 patients with no treatment for hypertension with 40 patients receiving hypouricemic therapy (HUT) with allopurinol, it was observed that mean serum uric acid decreased at all review visits in the allopurinol group, and there was a significant increase in mean eGFRcr after starting allopurinol (p < 0.001). None of the patients in the allopurinol group developed end-stage kidney disease (ESKD) within 24 months (p < 0.001). Similar results were not observed in the control group.

CONCLUSION

Allopurinol was useful in reducing serum uric acid levels, improving kidney function, and delaying progression to kidney failure in patients with AH.