Abstract: TH-PO831

Allopurinol Does Not Protect Renal Function in Patients on Peritoneal Dialysis

Session Information

  • Peritoneal Dialysis - I
    November 02, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

  • 608 Peritoneal Dialysis

Authors

  • Portela Neto, Antonio Abel, University State of São Paulo, São Paulo, Brazil
  • Elias, Rosilene M., University of Sao Paulo, Sao Paulo, São PAULO, Brazil
  • Moyses, Rosa M.A., Universidade Nove de Julho, São Paulo, Brazil
  • Abensur, Hugo, Universidade de Sao Paulo, Sao Paulo, Brazil
  • Pereira, Benedito J., University of Sao Paulo School of Medicine, Sao Paulo, Brazil
  • Cordeiro, Lilian, None, Sao Paulo, SÃO PAULO, Brazil
Background

Preservation of renal function in peritoneal dialysis (PD) patients is essential, since it is directly associated with increased survival in this method. Although there is evidence that allopurinol protects residual renal function (RRF) in patients with chronic renal disease not yet on dialysis, whether there is still benefit after these patients started PD is unknown. We therefore examined a cross-section of incident patients on PD to test the association between uric acid (UA) and the use of allopurinol with preservation of RRF.

Methods

Patients starting PD between January 2009 and December 2016 in an academic center, with demographic, clinical and laboratorial data were included. The outcome of interest was renal Kt/V, obtained in two moments: within the first 6 months of PD and at the end of the follow-up period. The difference between final and initial Kt/V was defined as Kt/V delta.

Results

Sixty-nine patients (age 47±18 years, 47% male, 79% hypertensive and 25% diabetic) were included. The UA was 7.2±1.8, ranging from 3.2 to 12.8 mg/dl. More than half of the patients (53.6%) presented UA higher than 7.0 mg/dl, with no difference in Kt/V delta [-0.33 (-0.55, -0.05 vs. -0.19 (-0.44, -0.01) in patients with UA higher and lower than 7.0 mg/dl, respectively; p = 0.382]. Delta Kt/V correlated with UA delta (r=-0.390, p=0.001), but it was not different between patients with and without allopurinol [-0.17 (-0.45; -0.01) vs. -0.29 (-0.66, 0.93; -0.02, respectively; p = 0.443]. Multiple regression analysis showed that neither UA nor UA delta (adjusted for allopurinol use) were independently associated with Kt/V delta.

Conclusion

The use of allopurinol had no impact on the preservation of RRF in patients on PD. In view of possible harm associated with allopurinol, prospective and interventional studies are required prior to recommendation of a regular prescription of such a drug for the PD population, as an attempt for renal preservation.