ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

ASN / Education & Meetings / Kidney Week /

Please note that you are viewing an archived section from 2020 and some content may be unavailable. To unlock all content for 2020, please visit the archives.

Abstract: PO0568

The Effects of Allopurinol on the Progression of CKD According to Baseline Serum Urate Level: Results from Post Hoc Analyses of the CKD-FIX Trial

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Tiku, Anushree, George Institute for Global Health, Sydney, New South Wales, Australia
  • Pascoe, Elaine, The University of Queensland, Saint Lucia, Queensland, Australia
  • Boudville, Neil, The University of Western Australia, Perth, Western Australia, Australia
  • Cass, Alan, Menzies School of Health Research, Casuarina, Northern Territory, Australia
  • Dalbeth, Nicola, The University of Auckland, Auckland, Auckland, New Zealand
  • Day, Richard O., St Vincent's Health Australia Ltd, Bondi Junction, New South Wales, Australia
  • de Zoysa, Janak, The University of Auckland, Auckland, Auckland, New Zealand
  • Douglas, Bettina, The University of Queensland, Saint Lucia, Queensland, Australia
  • Faull, Randall, The University of Adelaide, Adelaide, South Australia, Australia
  • Harris, David, The University of Sydney, Sydney, New South Wales, Australia
  • Hawley, Carmel, The University of Queensland, Saint Lucia, Queensland, Australia
  • Jones, Graham R D, University of New South Wales, Sydney, New South Wales, Australia
  • Kanellis, John, Monash University, Clayton, Victoria, Australia
  • Palmer, Suetonia, University of Otago, Dunedin, New Zealand
  • Perkovic, Vlado, George Institute for Global Health, Sydney, New South Wales, Australia
  • Rangan, Gopi, Westmead Hospital, Westmead, New South Wales, Australia
  • Reidlinger, Donna, The University of Queensland, Saint Lucia, Queensland, Australia
  • Robison, Laura, The University of Queensland, Saint Lucia, Queensland, Australia
  • Walker, Robert J., University of Otago, Dunedin, New Zealand
  • Walters, Giles, Australian National University, Canberra, Australian Capital Territory, Australia
  • Johnson, David W., The University of Queensland, Saint Lucia, Queensland, Australia
  • Badve, Sunil, George Institute for Global Health, Sydney, New South Wales, Australia
Background

Allopurinol did not slow decline in estimated glomerular filtration rate (eGFR) over 2 years in patients with chronic kidney disease (CKD) at risk of progression in the CKD-FIX trial. We assessed the effect of allopurinol on eGFR slope by baseline serum urate level.

Methods

In this trial, 369 adults with stage 3 or 4 CKD, without history of gout, and either urinary albumin-to-creatinine ratio ≥265 mg/g or eGFR decrease ≥3.0 mL/min/1.73 m2 in the preceding year, were randomized to allopurinol or placebo. The primary outcome was change in eGFR up to 104 weeks using the CKD-EPI creatinine equation. This post hoc subgroup analysis describes outcomes in 352 participants according to baseline serum urate level (normouricemic and hyperuricemic [serum urate >6 mg/dL in women and >7 mg/dL in men], and tertiles of baseline serum urate level).

Results

At baseline, 65 (18.5%) and 287 (81.5%) participants had normouricemia and hyperuricemia, respectively. The mean serum urate level in the normouricemic group was 5.9 mg/dL (4.8 mg/dL for women, 6.1 mg/dL for men), and mean serum urate in the hyperuricaemic group was 8.7 mg/dL (8.3 mg/dL for women and 8.9 mg/dL for men). There were no significant differences in change in eGFR between allopurinol and placebo in normouricemic (mean difference [MD] 0.35, 95%CI -2.72 to 3.42 mL/min/1.73 m2/year) and hyperuricemic (MD -0.06, 95%CI -1.20 to 1.08 mL/min/1.73 m2/year) participants (interaction P value = 0.84). The mean serum urate levels in the lowest, middle and highest tertiles were 6.3 mg/dL, 8.0 mg/dL and 10.0 mg/dL, respectively. The result for the primary outcome was consistent across all tertiles of baseline serum urate level (interaction P value for subgroup analysis = 0.49).

Conclusion

In CKD patients at risk of progression, the effect of allopurinol on eGFR decline was not modified by baseline serum urate.

Funding

  • Government Support - Non-U.S.