Abstract: TH-PO497

Reduction in Uric Acid Correlates with Better eGFR in Patients with Hyperuricemia and CKD Treated with XOIs – A Systematic Meta-Analysis

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 305 CKD: Clinical Trials and Tubulointerstitial Disorders

Authors

  • Erlandsson, Fredrik, AstraZeneca R&D, Gothenburg, Sweden
  • Johnsson, Eva K.A., AstraZeneca R&D, Gothenburg, Sweden
  • Hellsten kronander, Anna, AstraZeneca R&D, Gothenburg, Sweden
  • Bjursell, Magnus K, AstraZeneca R&D, Gothenburg, Sweden
  • Andersson, Magnus, AstraZeneca R&D, Gothenburg, Sweden
Background

Hyperuricemia may contribute to worsening of renal function in patients with chronic kidney disease (CKD). Uric acid (UA) lowering xanthine oxidase inhibitors (XOIs) may therefore preserve GFR.

Methods

TrialTrove was queried for studies with results using the terms “+Uricosuric agent or xanthine oxidase inhibitor”. Of 660 trials 8 were published randomized clinical trials in patients with hyperuricemia and CKD treated with XOI. The effect of XOI treatment relative to control on eGFR and the impact of reduction in serum uric acid on eGFR was assessed in a random effects meta-analysis model.

Results

Estimated GFR at end of treatment was significantly higher in the XOI arms (p<0.035) without significant heterogeneity in effect (p-value=0.075, I2- index: 45.7%). Greater reduction in UA correlated with better eGFR at the end of treatment (p<0.0062).

Conclusion

Renal function may benefit from intensive UA lowering therapy in CKD. Prospective studies of intensive UA lowering in CKD are warranted.

Included studies
 Follow upExperimental ArmControl Arm
ReferenceMonthsInterventionNInterventionN
Sircar 20156febuxostat45placebo48
Tani 20156febuxostat30placebo30
Sezai 20156febuxostat56allopurinol53
Kanbay 20104allopurinol30placebo37
Goicoechea 201024allopurinol56placebo57
Tanaka 20153febuxostat21placebo19
Shih 20126allopurinol21placebo19
Hosoya 20145.5topiroxostat60placebo60
  Total319Total323

Funding

  • Commercial Support