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Kidney Week

Abstract: FR-PO215

Urate-Lowering Therapy for Asymptomatic Hyperuricemia in Patients with CKD: Controversial Role of Renal Outcome

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Shin, Dong Ho, College of Medicine, Hallym University, Seoul, Korea (the Republic of)
  • Kim, Do Hyoung, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea (the Republic of)
  • Han, Chaehoon, kangnam secred heart hospital, Seoul, Korea (the Republic of)
  • Noh, Jung-woo, Hallym University, Seoul, Korea (the Republic of)
Background

Because serum uric acid increases as the glomerular filtration rate (GFR) falls, hyperuricemia has also been associated with chronic kidney disease (CKD). Although there are plausible evidences that hyperuricemia represents a risk factor for the progression of CKD, causal role of uric acid is still controversy in CKD patients with asymptomatic hyperuricemia.

Methods

We performed a retrospective single center study, enrolling 935 asymptomatic hyperuricemia patients with stage 3 - 4 CKD, between 2006 and 2018. By using propensity score matching, we matched 290 patients with and without urate-lowering therapy pairs from 935 patients. CKD progression was defined as a >30% reduction in GFR over 2 years. The changes in GFR over time compared between patients with and without urate-lowering therapy using a linear mixed model.

Results

In matched patients, the mean age was 63.2 ± 12.7 years, and 561 patients 60% was diabetic nephropathy. Mean estimated glomerular filtration rate (eGFR) was 44 ± 11 ml/min/1.73 m2. Serum uric acid level was significantly higher in treatment group 8 ± 2 vs 12 ± 3 mg/dL). During the mean follow-up of 120 ± 48 months, the proportion of CKD progression was not different between treatment group and no treatment group (41.5% vs. 39.5%, p = 0.34). In addition, the overall rate of decline in GFR was also comparable between two group (p = 0.45).

Conclusion

Uric acid-lowering therapy may be controversy in delaying the progression of CKD. Therefore, further randomized controlled trials should be performed to confirm the effect of urate-lowering therapy on the progression of CKD.