Related Experiment Video
Updated: Aug 5, 2026
Cardiac Loading using Passive Left Atrial Pressurization and Passive Afterload for Graft Assessment
Published on: August 2, 2024
A Randomized Controlled Trial to Evaluate Allopurinol Versus Placebo on Left Ventricular Mass in Living Kidney Donors
Nina Elisabeth Langberg1,2, Trond Geir Jenssen1,2, Einar Hopp3
1Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Insights
Allopurinol did not reduce left ventricular mass in living kidney donors, despite lowering uric acid levels. The treatment showed no significant impact on cardiovascular health markers or insulin sensitivity.
Area of Science:
- Nephrology
- Cardiology
- Clinical Trials
Background:
- Living kidney donation is generally safe but may pose long-term cardiovascular risks.
- Elevated uric acid is linked to increased left ventricular mass in donors.
- This study investigated if lowering uric acid could mitigate these risks.
Purpose of the Study:
- To determine if allopurinol reduces left ventricular mass in living kidney donors.
- To assess the impact of allopurinol on cardiovascular risk factors and insulin sensitivity.
Main Methods:
- A 9-month, randomized, double-blind, placebo-controlled trial involving 71 healthy kidney donors.
- Participants received either allopurinol 300 mg daily or a placebo.
- Left ventricular mass was measured using cardiac magnetic resonance imaging (CMR).
Main Results:
- Allopurinol significantly lowered uric acid levels compared to placebo.
- No significant difference in left ventricular mass change was observed between groups.
- Allopurinol did not affect blood pressure or insulin sensitivity.
Conclusions:
- Nine months of allopurinol treatment did not reduce left ventricular mass in living kidney donors.
- The drug did not improve cardiovascular markers or insulin sensitivity in this population.
- Further research may be needed to explore other interventions for donor cardiovascular health.
Key Points:
Donation of a kidney is regarded safe, although it may be associated with increased long-term cardiovascular risks. This is the first study to evaluate if allopurinol has any benefits on left ventricular mass, ambulatory BP, and insulin resistance in kidney donors. We found no clinically relevant positive impact of 9 months of allopurinol treatment on cardiovascular risk factors in living kidney donors.
Background:
Living kidney donation is regarded safe, although recent studies raise concern on long-term cardiovascular risks, including left ventricular mass (LVM) and hypertension, resulting in higher cardiovascular mortality. Elevated uric acid has been associated with higher LVM. We therefore hypothesized that lowering uric acid can reduce LVM in living kidney donors.
Methods:
The study was a single-center, phase 2b efficacy, 1:1 randomized, double-blind, placebo-controlled trial over 9 months. Participants ( n =71) were healthy kidney donors aged 18+ years with eGFR >30 ml/min per 1.73 m 2 examined ≥6 months after donor nephrectomy. The intervention consisted of allopurinol 300 mg or placebo once daily for 9 months, and the main outcome was change in LVM from baseline to month 9 in the allopurinol group compared with placebo, evaluated by the use of cardiac magnetic resonance imaging.
Results:
Uric acid levels were significantly lower in the allopurinol group ( P < 0.001). We found no significant differences between the changes in magnetic resonance imaging-estimated LVM between the treatment groups. The mean changes were -0.25 (±4.4) g in the allopurinol group and 1.04 (±4.2) g in the placebo group ( P = 0.25). There was no effect of allopurinol on BP ( P = 0.98) or indexes of insulin sensitivity ( P = 0.62). Adverse events occurred in 28 (39%) participants, 18 (70%) in the allopurinol group and ten (37%) in the placebo group. Three events were considered severe, all in the allopurinol group.
Conclusions:
We found no effects on LVM, BP, or insulin sensitivity of 9 months of allopurinol treatment in living kidney donors, despite a significant effect on uric acid.
Clinical Trial Registry Name And Registration Number:
NCT03353298 .
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure