Kidney Week

Abstract: PO1812

Potential Benefits of Asymptomatic Hyperuricemia Treatment: A Systematic Review and Meta-Analysis of Randomized Control Trials

Session Information

• Hypertension and CVD: Clinical, Outcomes, and Trials
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

• Gala, Dhir N., American University of the Caribbean School of Medicine BV, Cupecoy, Sint Maarten (Dutch part)

Dhir N. Gala

• Said, Kirellos Said Abbas, Alexandria University Faculty of Medicine, Alexandria, Egypt

Kirellos Said Abbas Said,

• El-Shahat, Nahla Ahmed, Al-Azhar University Faculty of Medicine, Cairo, Egypt

Nahla Ahmed El-Shahat,

• Parrill, Allison, American University of the Caribbean School of Medicine BV, Cupecoy, Sint Maarten (Dutch part)

Allison Parrill,

• Mohamed, Hadeir Said, Al-Azhar University Faculty of Medicine, Cairo, Egypt

Hadeir Said Mohamed,

• Abdelhalim, Nada, Istanbul Gelisim Universitesi, Istanbul, Istanbul, Turkey

Nada Abdelhalim,

• Amin, Mostafa Atef, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt

Mostafa Atef Amin,

• Abdalshafy, Hassan Sayed, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt

Hassan Sayed Abdalshafy,

• Alahmar, Majd, Mansoura University Faculty of Medicine, Mansoura, Egypt

Majd Alahmar,

• Huy, Nguyen Tien, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan

Nguyen Tien Huy,

• Abdel Gawad, Mohammed, Gawad Nephrology Clinic, Alexandria, Egypt

Mohammed Abdel Gawad,

Background

Asymptomatic hyperuricemia is strongly associated with an increased risk for chronic kidney disease and cardiovascular conditions. However, many current guidelines suggest no medical treatment for patients with asymptomatic hyperuricemia. We aim to systematically analyze randomized control trials with serum uric acid-lowering medication in the treatment of patients with asymptomatic hyperuricemia.

Methods

A literature review of seven medical databases (Scopus, Clinical Gov, Pubmed, Web of Science, Google Scholar, VHL, and GHL) for randomized controlled trials related to the treatment of asymptomatic hyperuricemia was conducted. Bias was evaluated using the Cochrane Risk of Bias 2 tool. Standard differences of means of variables of interest were combined across studies to compare the effects of uric acid lowering treatment versus control. Using the Comprehensive Meta-Analysis program, fixed-effects and random heterogeneity model, forest plots were created for each variable of interest.

Results

Analysis of eleven studies showed significant decreases in creatinine [-0.302 (95% CI: -0.599, -0.005)], systolic blood pressure [-0.277 (95% CI: -0.5, -0.055)], and serum uric acid [-1.972 (95% CI: -2.145, -1.800)] in the treatment versus control group. Furthermore, significant increases in estimated glomerular filtration rate (eGFR) after sensitivity analysis [0.228 (95% CI: 0.027, 0.428)], and high-sensitivity C-reactive protein [0.588 (95% CI: 0.205, 0.971)] were observed in the treatment versus control group. Lastly, non-significant decreases in carotid intima-media thickness test [-0.113 (95% CI: -0.269, 0.042)], and diastolic blood pressure [-0.312 (95% CI: -0.638, 0.013)], while non-significant increases in hemoglobin A1C [0.394 (95% CI: -0.026, 0.813)] and fasting glucose level [0.117 (95% CI: -0.145, 0.380)] were found in the treatment versus control group.

Conclusion

This study showed that uric acid lowering treatment of patients with asymptomatic hyperuricemia may be beneficial in those with elevated creatinine and blood pressure, and decreased eGFR.