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Effectiveness of Urate-Lowering Therapy for Renal Function in Patients With Chronic Kidney Disease: A Meta-Analysis

Xiuping Liang1,2, Xiang Liu3,2, Duohui Li2

  • 1Department of Rheumatology and Immunology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.

Frontiers in Pharmacology
|April 4, 2022
PubMed

Insights

Urate-lowering therapy (ULT) effectively reduces serum uric acid in chronic kidney disease (CKD) patients. However, current evidence does not demonstrate significant renoprotective benefits of ULT in CKD, though it appears safe.

Area of Science:

  • Nephrology
  • Pharmacology
  • Clinical Trials

Background:

  • Hyperuricemia is a known comorbidity of chronic kidney disease (CKD).
  • The efficacy and safety of urate-lowering therapy (ULT) for renal outcomes in CKD patients remain uncertain.
  • This meta-analysis evaluates the effectiveness of ULT in improving kidney function in CKD.

Approach:

  • A systematic meta-analysis of randomized clinical trials (RCTs) was conducted.
  • Data were sourced from PubMed, Embase, MEDLINE, and Cochrane Central Register of Controlled Trials.
  • Outcomes included changes in renal function, serum uric acid (SUA), serum creatinine, and adverse events.

Key Points:

  • ULT significantly lowered SUA levels (SMD: -2.70; 95% CI: -3.71, -1.69).
  • No significant renoprotective effects of ULT were observed compared to control therapies.
  • Subgroup and sensitivity analyses confirmed the stability of these findings.
  • Adverse event risks were not elevated in the ULT group.

Conclusions:

  • ULT effectively reduces SUA in CKD patients.
  • Insufficient evidence currently supports the renoprotective role of ULT in CKD.
  • ULT is considered safe for use in CKD patients.

Keywords:
ULTchronic kidney diseasehyperuricemiameta-analysisrenal function

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