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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Allopurinol benefits left ventricular mass and endothelial dysfunction in chronic kidney disease

Michelle P Kao1, Donald S Ang, Stephen J Gandy

  • 1Division of Medical Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom. mpckao@doctors.org.uk

Journal of the American Society of Nephrology : JASN
|July 2, 2011
PubMed

Insights

Allopurinol significantly reduced left ventricular hypertrophy (LVH) and improved endothelial function in patients with chronic kidney disease (CKD). These findings suggest allopurinol may offer cardiovascular benefits for this population.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Allopurinol is known to improve endothelial function and arterial stiffness in non-CKD patients.
  • The effects of allopurinol on cardiovascular parameters in patients with chronic kidney disease (CKD) remain unclear.
  • Arterial stiffness contributes to left ventricular hypertrophy (LVH) by increasing afterload.

Purpose of the Study:

  • To investigate the efficacy of allopurinol in reducing LVH and improving endothelial function in patients with stage 3 CKD.
  • To assess the impact of allopurinol on arterial stiffness in this patient cohort.

Main Methods:

  • A randomized, double-blind, placebo-controlled, parallel-group study.
  • 67 patients with stage 3 CKD and LVH were assigned to receive either allopurinol (300 mg/d) or placebo for 9 months.
  • Left ventricular mass index (LVMI) was measured by cardiac MRI, endothelial function by flow-mediated dilation (FMD), and arterial stiffness by pulse-wave analysis.

Main Results:

  • Allopurinol significantly reduced LVH (P=0.036).
  • Allopurinol significantly improved endothelial function (P=0.009).
  • Allopurinol significantly improved the central augmentation index, a measure of arterial stiffness (P=0.015).

Conclusions:

  • Allopurinol treatment effectively regresses left ventricular mass and enhances endothelial function in patients with CKD.
  • Given the association of LVH and endothelial dysfunction with poor prognosis, these findings warrant further investigation into allopurinol's potential to reduce cardiovascular events in CKD patients.

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