Colchicine use and the risk of CKD progression: a multicentre nested case-control study

Area of Science:

• Nephrology
• Pharmacology
• Internal Medicine

Background:

• Preclinical studies suggest colchicine protects against kidney fibrosis.
• The effect of colchicine on chronic kidney disease (CKD) progression in humans is not well-established.
• Patients with hyperuricemia or chronic gout are at risk for CKD progression.

Purpose of the Study:

• To investigate the association between long-term colchicine use and adverse kidney outcomes in patients with CKD.
• To determine if colchicine can delay the progression of chronic kidney disease in a human population.
• To evaluate the risk of CKD progression in patients treated for hyperuricemia or chronic gout.

Main Methods:

• A multicentre, nested, case-control study was conducted in three Korean hospitals.
• Patients aged ≥19 years with CKD G3-G4 using colchicine, allopurinol, or febuxostat were included.
• CKD progression was defined as a ≥40% decrease in estimated glomerular filtration rate or kidney failure; cases were matched to controls.

Main Results:

• 3085 patients with CKD progression were matched to 11,715 control patients.
• Patients with ≥90 cumulative daily colchicine doses showed a lower risk of CKD progression (AOR, 0.77; 95% CI: 0.61, 0.96).
• This association was more significant in patients without diabetes or hypertension, and in those with CKD G3.

Conclusions:

• Colchicine use is associated with a reduced risk of adverse kidney outcomes in CKD patients.
• The findings support a potential renoprotective role for colchicine in patients with hyperuricemia or chronic gout.
• Further research may elucidate the mechanisms and clinical applications of colchicine in CKD management.